Sickle cell trait and renal disease among African American U.S. Army soldiers

Br J Haematol. 2019 May;185(3):532-540. doi: 10.1111/bjh.15820. Epub 2019 Mar 11.

Abstract

Sickle cell trait and certain renal disorders are disproportionately prevalent among African American individuals, so a clear understanding of their association is important. We conducted a longitudinal study using the Stanford Military Data Repository to examine sickle cell trait in relation to the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD). Our study population consisted of African American U.S. Army soldiers on active duty between January 2011 and December 2014. The cumulative incidence was 0·51% for AKI (236 cases out of 45 901 soldiers) and 0·56% for CKD (255 cases out of 45 882 soldiers). Discrete time logistic regression models adjusting for demographic-, military- and healthcare-related covariates showed that sickle cell trait was associated with significantly higher adjusted odds of both AKI [odds ratio (OR): 1·74; 95% confidence interval (CI): 1·17-2·59] and CKD (OR: 2·00; 95% CI: 1·39-2·88). Elevated odds of AKI and CKD were also observed in association with prior CKD and AKI, respectively, and with obesity and prior hypertension. Individuals with sickle cell trait and their providers should be aware of the possibility of increased risk of AKI and CKD to allow for timely intervention and possible prevention.

Keywords: acute kidney injury; chronic kidney disease; epidemiology; military; sickle cell trait.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Black or African American*
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / ethnology
  • Kidney Diseases* / epidemiology
  • Kidney Diseases* / ethnology
  • Kidney Diseases* / etiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Military Personnel*
  • Obesity / complications
  • Obesity / epidemiology
  • Obesity / ethnology
  • Risk Factors
  • Sickle Cell Trait* / complications
  • Sickle Cell Trait* / epidemiology
  • Sickle Cell Trait* / ethnology
  • United States / epidemiology