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Abstract: PO2355

Prevalence and Determinants of Sickle Cell Nephropathy in Children Living in a Low-Resource Setting

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Adebayo, Oyindamola Christiana, Laboratory of Pediatric Nephrology, Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
  • Betukumesu Kabasele, Dieumerci, Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
  • Nkoy, Agathe Bikupe, Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
  • Ekulu, Pepe Mfutu, Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
  • Labarque, Veerle, Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
  • Van den heuvel, Lambertus P.W.J., Laboratory of Pediatric Nephrology, Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
  • Levtchenko, Elena N., Laboratory of Pediatric Nephrology, Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
Background

Clinical and genetic factors have been reported to influence the development of sickle cell nephropathy (SCN). However, data on the association between these factors and SCN remain limited in the pediatric population, especially in sub-Saharan Africa. Our study aimed to: (i) determine the prevalence of the reported markers of SCN, including albuminuria, glomerular hyperfiltration and reduced kidney function in a pediatric sickle cell anemia (SCA) population from the Democratic Republic of Congo (DRC); (ii) examine the association between these SCN markers and some clinical and genetic factors.

Methods

Clinical parameters were collected. All participants were genotyped for Apolipoprotein-L1 (APOL1) G1 (rs73885319, rs60910145) and G2 (rs71785313) variants, and for Heme oxygenase 1 (HMOX1) GT dinucleotide repeats (rs3074372). APOL1 high-risk genotype (HRG) was defined by the presence of 2 risk variants (G1/G1, G2/G2, and G1/G2) and low risk genotype (LRG) if 0 or 1 risk variants were present. HMOX1 GT dinucleotide repeats were categorized into two allele classes (≤ 25 repeats as short and > 25 repeats as long). As the main outcomes, albuminuria was defined as albumin-to-creatinine ratio (ACR) ≥ 30mg/g, reduced kidney function (eGFR <60 ml/min per 1.73 m2) and glomerular hyperfiltration (eGFR > 130 and 140 ml/min/1.73 m2 for female and male, respectively).

Results

From 361 participants enrolled, 73 (20.2%) presented with albuminuria, 104 (28.8%) with hyperfiltration and 19 (5.26%) had reduced kidney function. Logistic regression analysis revealed that blood transfusions (> 9 per year) were significantly associated with albuminuria (P = 0.036); age (P = 0.015) and diastolic hypertension (P = 0.0099) were significantly associated with hyperfiltration. APOL1 HRG emerged as the main genetic factor associated with both albuminuria (odds ratio [OR]: 3.70, 95% confidence interval [CI]: -0.0037—2.55; P = 0.041) and hyperfiltration (OR: 21.84, 95% CI: 1.51—5.20; P < 0.001), while no association was found with HMOX1 GT repeats.

Conclusion

Kidney disease is highly prevalent in children with SCA in the DRC. APOL1 HRG is the main determinant associated with the risk of developing SCN.

Funding

  • Government Support - Non-U.S.