Sickle cell trait is not independently associated with susceptibility to end-stage renal disease in African Americans

Pamela J. Hicks, Carl D. Langefeld, Lingyi Lu, Anthony J. Bleyer, Jasmin Divers, Patrick H. Nachman, Vimal K. Derebail, Donald W. Bowden, Barry I. Freedman

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31 Scopus citations


Conflicting reports exist as to whether sickle cell trait is a risk factor for the progression of nephropathy. In order to determine whether African Americans with sickle cell trait are at increased risk for kidney disease, we assessed the genetic association between sickle cell trait and end-stage renal disease (ESRD). Hemoglobin S, non-muscle myosin heavy chain 9 (MYH9), and apolipoprotein L1 (APOL1) risk variants were genotyped in 3258 unrelated African Americans: 1085 with non-diabetic ESRD, 996 with type 2 diabetes-associated ESRD, and 1177 controls. Since APOL1 is strongly associated with ESRD in African Americans, interactions between APOL1 and MYH9 risk variants and hemoglobin S were assessed using case-only and case-control centered two-way logistic regression interaction analyses. The sickle cell trait genotype frequencies were 8.7% in non-diabetic ESRD, 7.1% in type 2 diabetes-ESRD, and 7.2% in controls. There was no age-, gender-, and admixture-adjusted significance for sickle cell trait association with non-diabetic ESRD (odds ratio 1.16); type 2 diabetes-ESRD (odds ratio 1.01); or all-cause ESRD (combined non-diabetic and type 2 diabetic-ESRD patients compared to the controls; odds ratio 1.05) in dominant models. In addition, no evidence of APOL1 or MYH9 interactions with sickle cell trait was detected. Hence, sickle cell trait is not associated with diabetic or non-diabetic ESRD in a large sample of African Americans.

Original languageEnglish (US)
Pages (from-to)1339-1343
Number of pages5
JournalKidney international
Issue number12
StatePublished - Dec 2 2011
Externally publishedYes

Bibliographical note

Funding Information:
We thank all the study participants and study coordinators: Mitzie Spainhour, Joyce Byers, Sharon Warren, Carrie Smith, and Cassandra Bethea. This work was supported by NIH grants: R01 DK066358 (DWB), R01 DK053591 (DWB), R01 HL56266 (BIF), RO1 DK070941 (BIF), RO1 DK084149 (BIF), and in part by the General Clinical Research Center of the Wake Forest School of Medicine grant M01 RR07122.


  • APOL1
  • African American
  • diabetes
  • end-stage kidney disease
  • hemoglobin S
  • hypertension


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