Clinical and genetic predictors of renal dysfunctions in sickle cell anaemia in Cameroon

Summary Micro‐albuminuria and glomerular hyperfiltration are primary indicators of renal dysfunctions in Sickle Cell Disease ( SCD ), with more severe manifestations previously associated with variants in APOL 1 and HMOX 1 among African Americans. We have investigated 413 SCD patients from Cameroon. Anthropometric variables, haematological indices, crude albuminuria, albumin‐to‐creatinine ratio ( ACR ) and estimated glomerular filtration rate ( eGFR ) were measured. Patients were genotyped for 3·7 kb alpha‐globin gene ( HBA 1/ HBA 2 ) deletion, and for variants in APOL 1 (G1/G2; rs60910145, rs73885319, rs71785313) and HMOX 1 (rs3074372, rs743811). The median age was 15 years; the majority presented with micro‐albuminuria (60·9%; n  =   248), and approximately half with glomerular hyperfiltration (49·5%; n  =   200). Age, male sex, haemoglobin level, leucocyte count, mean corpuscular volume, blood pressure, body mass index and creatinine levels significantly affected albuminuria and/or eGFR . Co‐inheritance of alpha‐thalassaemia was protective against macro‐albuminuria ( P  = 0·03). APOL 1 G1/G2 risk variants were significantly associated with the ACR ( P  = 0·01) and borderline with eGFR ( P  = 0·07). HMOX 1 ‐ rs743811 was borderline associated with micro‐albuminuria ( P  = 0·07) and macro‐albuminuria ( P  = 0·06). The results revealed a high proportion of micro‐albuminuria and glomerular hyperfiltration among Cameroonian SCD patients, and support the possible use of targeted genetic biomarkers for risks assessment.