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Sickle Cell Trait and Kidney Disease in People of African Ancestry With HIV

Lookup NU author(s): Dr David Price, Tara Stothard, Dr Ciara Kennedy, Dr Brendan PayneORCiD, Dr Sarah Duncan, Dr Christopher DuncanORCiD, Dr Ewan Hunter, Dr Yusri Taha

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Abstract

© 2021 International Society of Nephrology. Introduction: Sickle cell trait (SCT) has been associated with chronic kidney disease (CKD) in African Americans, although evidence for its impact in Africans and people with HIV is currently lacking. We conducted a cross-sectional study investigating the association between SCT and kidney disease in people of African ancestry with HIV in the UK. Methods: The primary outcome was estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. Secondary outcomes were eGFR <90 ml/min per 1.73 m2, end-stage kidney disease (ESKD; eGFR <15 ml/min per 1.73 m2, chronic dialysis, or having received a kidney transplant), proteinuria (protein-to-creatinine ratio >50 mg/mmol), and albuminuria (albumin-to-creatinine ratio >3 mg/mmol). Multivariable logistic regression was used to estimate the associations between SCT and kidney disease outcomes. Results: A total of 2895 participants (mean age 48.1 [SD 10.3], 57.2% female) were included, of whom 335 (11.6%) had SCT and 352 (12.2%) had eGFR <60 ml/min per 1.73 m2. After adjusting for demographic, HIV, and kidney risk factors including APOL1 high-risk genotype status, individuals with SCT were more likely to have eGFR <60 ml/min per 1.73 m2 (odds ratio 1.62 [95% CI 1.14–2.32]), eGFR <90 ml/min per 1.73 m2 (1.50 [1.14–1.97]), and albuminuria (1.50 [1.09–2.05]). Stratified by APOL1 status, significant associations between SCT and GFR <60 ml/min per 1.73 m2, eGFR <90 ml/min per 1.73 m2, proteinuria, and albuminuria were observed for those with APOL1 low-risk genotypes. Conclusion: Our results extend previously reported associations between SCT and kidney disease to people with HIV. In people of African ancestry with HIV, these associations were largely restricted to those with APOL1 low-risk genotypes.

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Author(s): Hung RKY, Binns-Roemer E, Booth JW, Hilton R, Fox J, Burns F, Harber M, Ustianowski A, Hamzah L, Burns JE, Clarke A, Price DA, Kegg S, Onyango D, Santana-Suarez B, Campbell L, Bramham K, Sharpe CC, Sabin CA, Winkler CA, Post FA, Booth J, Waters A, Hand J, Clarke C, Murphy S, Murphy M, Campbell M, Richardson C, Knott A, Weir G, Cleig R, Soviarova H, Barbour L, Adams T, Kennard V, Trevitt V, Jones R, Levy J, Schoolmeester A, Duro S, Rabuya M, Jordan D, Solano T, Uzu H, Williams K, Lwanga J, Reid-Amoruso LE, Gamlen H, Stocker RJ, Ryan F, Mahiouz K, Cheetham T, Williams C, Nori A, Thomas C, Venkateshwaran S, Doctor J, Berlanga A, Post F, McQueen L, Bhagwandin P, Barbini B, Wandolo E, Appleby T, Driver L, Parr S, Deng H, Barber J, Crowe A, Taylor C, Poulton M, Boateng V, Klein M-P, O'Brien C, Ohene-Adomako S, Buckingham C, Trotman D, Quinn K, Flanagan K, Sullivan V, Middleditch H, Samuel I, Hamlyn E, McDonald C, Canoso A, Agbasi E, Liskova M, Barber S, Samarawickrama A, Ottaway Z, Norcross C, Oliveira A, Minton J, Lamont G, Cross R, Saiyad G, Ahmed S, Ashworth R, Window N, Murira J, Phyu K, Lindergard G, Shaw J, Holland S, Fox C, Flaherty J, Bevan M-A, George V, Chadwick D, Branch M, Lambert P, Craggs A, Pett S, Lukha H, Vora N, Fiorino M, Nunez MM, Sally D, Pool E, Matthews R, Price DA, Stothard T, Patel B, McVittie I, Kennedy C, Shwab U, Payne B, Duncan S, Dixon J, Schmid M, Evans A, Duncan C, Hunter E, Taha Y, Astill N, Winkler C, David V, Ainsworth J, Vincent R, Saad C, Skinner S, Azzoug H, Russell J, Moussaoui T, Mabonga E, Ward D, Francoise J, Larbi W, Mitchell S, Manning A, Russell V, Ngwu N, Edwards J, Hemat N, Fernandez T, Ferro F, Ferreira J, Nightingale A, Oakes-Monger T, Matila D, Nogueira P, Mutagwanya V, Cosgrove C, Isitt CE, Webb H, Popoola J, Korley K, Mencias M, Ribeiro P, Ramkhelawn R, Lara SO, Sajijad S, Winston A, Shaw A, Petersen C, Ring K, Rosenvinge M, Moyo T, Odong F, Gantert K, Ibe T, Sabin C, Hill T

Publication type: Article

Publication status: Published

Journal: Kidney International Reports

Year: 2022

Volume: 7

Issue: 3

Pages: 465-473

Print publication date: 03/03/2022

Online publication date: 13/12/2021

Acceptance date: 06/12/2021

Date deposited: 04/02/2022

ISSN (electronic): 2468-0249

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.ekir.2021.12.007

DOI: 10.1016/j.ekir.2021.12.007

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