Abstract: FR-PO413

CKD Progression in Patients with Sickle Cell Trait

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Olaniran, Kabir O., Massachusetts General Hospital, Malden, Massachusetts, United States
  • Eneanya, Nwamaka Denise, Massachusetts General Hospital, Malden, Massachusetts, United States
  • Allegretti, Andrew S., Massachusetts General Hospital, Malden, Massachusetts, United States
  • Xu, Dihua, Massachusetts General Hospital, Malden, Massachusetts, United States
  • Thadhani, Ravi I., Massachusetts General Hospital, Malden, Massachusetts, United States
Background

Sickle cell trait (SCT) has been shown in recent studies to be independently associated with incident CKD and progression to end stage renal disease (ESRD). We sought to confirm the risk for ESRD and glomerular filtration rate (GFR) decline in a multi-hospital cohort.

Methods

This was a multi-hospital retrospective cohort study in Boston using adult KDIGO criteria CKD patients between 2005-2017. Chart review was used to ascertain the following exposures: SCT and the reference group (RG; black race with CKD and normal hemoglobin electrophoresis). Primary outcomes were ESRD on dialysis (identified by diagnosis codes) and GFR decline (defined as a decrease in GFR ≧1ml/min per follow up year). Exposures confirmed by diagnosis code only were then added for sensitivity analysis.

Results

915 CKD subjects were initially included (241 SCT and 674 RG). Baseline age was 54±15 years in SCT CKD and 52±17 years in the RG, p=0.266. The mean baseline GFR in SCT CKD patients was similar vs the RG (69±33ml/min vs 70±36ml/min, p=0.57) with similar proportions per CKD stage. Treatment with renin-angiotensin system inhibitors was not significantly different (88% SCT CKD vs 85% RG, p=0.26). No other significant differences in the baseline characteristics of the SCT CKD vs the RG were noted including smoking status, co-morbidities and treatments. After adjustment for age, co-morbidities and medications, we found significantly increased odds for GFR decline in SCT CKD (OR 1.7, 95% CI 1.1-2.6) compared to the RG. SCT CKD patients also had significantly increased odds for dialysis (OR 1.8, 95% CI 1.04-2.98) after multivariable analysis. Sensitivity analysis of 8,580 subjects (360 SCT and 8,220 RG) found similar results for GFR decline (OR 1.6, 95% CI 1.2-2.2) and dialysis (OR 1.9, 95% CI 1.3-2.9).

Conclusion

SCT with concurrent CKD is associated with an increased risk for GFR decline and requirement for dialysis in our cohort. More detailed studies are needed to determine risk factors for progression in this patient population.