Clinical and metabolomic risk factors associated with rapid renal function decline in sickle cell disease

American Journal of Hematology
Julia Z XuMarilyn J Telen

Abstract

Sickle cell disease (SCD) nephropathy and lower estimated glomerular filtration rate (eGFR) are risk factors for early mortality. Furthermore, rate of eGFR decline predicts progression to end-stage renal disease in many clinical settings. However, factors predicting renal function decline in SCD are poorly documented. Using clinical, laboratory, genetic, and metabolomic data, we evaluated predictors of renal function decline in a longitudinal cohort of 288 adults (mean age 33.0 years). In 193 subjects with 5-year follow-up data, mean rate of eGFR decline was 2.35 mL/min/1.73 m2 /year, nearly twice that of African American adults overall. Hyperfiltration was prevalent at baseline (61.1%), and 36.8% of subjects experienced rapid eGFR decline (≥3 mL/min/1.73 m2 /year). Severe Hb genotype; proteinuria; higher platelet and reticulocyte counts, and systolic BP; and lower Hb level and BMI were associated with rapid decline. A risk scoring system was created using these 7 variables and was highly predictive of rapid eGFR decline, with odds of rapid decline increasing 1.635-fold for every point increment (P < 0.0001). Rapid eGFR decline was also associated with higher organ system severity score and peak creatinine. Additionally, two me...Continue Reading

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Citations

Nov 25, 2020·Transfusion·Carla L DinardoUNKNOWN NHLBI Recipient Epidemiology Donor Evaluation Study (REDS-III) International Component-Brazil, the Outcome Modifying Genes i
Jun 11, 2021·American Journal of Hematology·Camille RogerJean-Philippe Haymann

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