Introduction:
Sickle cell trait (SCT) is an independent risk factor for chronic kidney disease (CKD). CKD is a well-established risk factor for progressive cardiovascular dysfunction. Sickle Cell trait has been noted to promote a persistent systemic pro-inflammatory state. This pro-inflammatory state could potentially increase the risk of systemic endothelial dysfunction when accompanied with other cardiotoxic conditions. We aim to investigate cardiovascular outcomes in patients with SCT and CKD, compared to SCT alone.
Methods:
Patients with CKD were identified in the National Inpatient Sample (NIS) database 2016 using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), and subsequently were divided into two groups, those with and without SCT. Both population sets were paired using 1:1 propensity score matching based on Age, Sex and co-morbidities to address potential confounding factors. Outcomes of interest were overall mortality, rates of stroke, sudden cardiac arrest (SCA) and cardiomyopathy.
Results:
Mean age of patients with CKD alone was 72.98 ± 13.2 years, while for CKD and SCT 56.68 ± 17.3 years. There was no significant difference between the two group in the rates of stroke (1.3% vs 1.0%; P= 0.125), and SCA (1.0% vs 1.1%; P= 0.841). Overall mortality (5.7% vs 2.2%; P<0.0001) and rates of cardiomyopathy (10.1% vs 2.9%; P<0.0001) were significantly lower in patients with CKD and SCT, compared to CKD alone. Multivariate logistic regression followed a similar trend, compared to those with CKD alone, the adjusted odds ratio (aOR) for overall mortality aOR; 0.625 (0.372-1.049) and cardiomyopathy aOR; 0.451 (0.293-0.696) were significantly lower in patients with CKD and SCT.
Conclusion:
Compared to patients with CKD alone, those with CKD and SCT have a lower risk for overall mortality and cardiomyopathy. Further studies are needed to replicate this finding and look at the possible protective role of SCT in patients with CKD.
Sickle Cell Trait and Sudden Death
