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Ilori TO, Solarin A, Manmak M, Raji YR, Braimoh R, Kwakyi E, Umeizudike T, Ajepe T, Bolanle O, Ripiye N, Eduful E, Adebile T, Ijeoma C, Mumuni AA, Chern J, Akinpelu M, Ulasi I, Arogundade F, Salako BL, Gbadegesin R, Parekh RS, Dupuis J, Amira CO, Adu D, Anderson CA, Ojo A, Waikar SS. Rationale and Design of the Diet, CKD, and Apolipoprotein L1 Study in Low-Income and Middle-Income Countries. Kidney Int Rep 2023; 8:764-774. [PMID: 37069986 PMCID: PMC10105057 DOI: 10.1016/j.ekir.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Diet, chronic kidney disease (CKD), and Apolipoprotein L1 (APOL1) (DCA) Study is examining the role of dietary factors in CKD progression and APOL1 nephropathy. We describe enrollment and retention efforts and highlight facilitators and barriers to enrollment and operational challenges, as well as accommodations made in the study protocol. Methods The DCA study is enrolling participants in 7 centers in West Africa. Participants who consented were invited to complete dietary recalls and 24-hour urine collections in year 1. We conducted focus groups and semistructured interviews among study personnel to identify facilitators and barriers to enrollment as well as retention and operational challenges in the execution of the study protocol. We analyzed emerging themes using content analyses. Results A total of 712 participants were enrolled in 18 months with 1256 24-hour urine and 1260 dietary recalls. Barriers to enrollment were the following: (i) a lack of understanding of research, (ii) the burden of research visits, and (iii) incorporating cultural and traditional nuances when designing research protocols. Factors facilitating enrollment were the following: (i) designing convenient research visits, (ii) building rapport and increased communication between the research team and participants, and (iii) cultural sensitivity - adapting research protocols for the populations involved. Offering home visits, providing free dietary counseling, reducing the volume of study blood collection, and reducing the frequency of visits were some changes made in the study protocol that increased participant satisfaction. Conclusion Adopting a participant-centered approach with accommodations in the protocol for cultural adaptability and incorporating participant feedback is vital for carrying out research in low-income and middle-income regions.
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Affiliation(s)
- Titilayo O. Ilori
- Division of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine Boston, Massachusetts, USA
| | - Adaobi Solarin
- Department of Pediatrics and Child Health, College of Medicine, Lagos State University, Nigeria
| | - Mamven Manmak
- Department of Internal Medicine, University of Abuja, Nigeria
| | - Yemi R. Raji
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rotimi Braimoh
- Department of Medicine, College of Medicine, University of Lagos, Nigeria
| | - Edward Kwakyi
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Ghana
| | | | - Titilope Ajepe
- Department of Physiotherapy, College of Medicine, University of Lagos, Nigeria
| | - Omotoso Bolanle
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Nanna Ripiye
- Department of Internal Medicine, University of Abuja, Nigeria
| | - Ernestina Eduful
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Ghana
| | - Temitayo Adebile
- Division of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine Boston, Massachusetts, USA
| | | | - Amisu A. Mumuni
- Department of Medicine, College of Medicine, Lagos State University, Nigeria
| | - Jessica Chern
- Division of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine Boston, Massachusetts, USA
| | - Morenikeji Akinpelu
- Division of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine Boston, Massachusetts, USA
| | | | - Fatiu Arogundade
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Babatunde L. Salako
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rasheed Gbadegesin
- Department of Pediatrics, Department of Medicine, Duke University School of Medicine, North Carolina, USA
| | - Rulan S. Parekh
- Department of Medicine, Women’s College Hospital, Hospital for Sick Children and University of Toronto, Ontario, Canada
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | | | - Dwomoa Adu
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Ghana
| | - Cheryl A.M. Anderson
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Akinlolu Ojo
- Department of Medicine, Kansas University Medical Center, The University of Kansas, Kansas, USA
| | - Sushrut S. Waikar
- Division of Nephrology, Department of Medicine, Boston Medical Center, Boston University School of Medicine Boston, Massachusetts, USA
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Ilori T, Watanabe A, Ng KH, Solarin A, Sinha A, Gbadegesin R. Genetics of Chronic Kidney Disease in Low-Resource Settings. Semin Nephrol 2022; 42:151314. [PMID: 36801667 PMCID: PMC10272019 DOI: 10.1016/j.semnephrol.2023.151314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Advances in kidney genomics in the past 20 years has opened the door for more precise diagnosis of kidney disease and identification of new and specific therapeutic agents. Despite these advances, an imbalance exists between low-resource and affluent regions of the world. Individuals of European ancestry from the United States, United Kingdom, and Iceland account for 16% of the world's population, but represent more than 80% of all genome-wide association studies. South Asia, Southeast Asia, Latin America, and Africa together account for 57% of the world population but less than 5% of genome-wide association studies. Implications of this difference include limitations in new variant discovery, inaccurate interpretation of the effect of genetic variants in non-European populations, and unequal access to genomic testing and novel therapies in resource-poor regions. It also further introduces ethical, legal, and social pitfalls, and ultimately may propagate global health inequities. Ongoing efforts to reduce the imbalance in low-resource regions include funding and capacity building, population-based genome sequencing, population-based genome registries, and genetic research networks. More funding, training, and capacity building for infrastructure and expertise is needed in resource-poor regions. Focusing on this will ensure multiple-fold returns on investments in genomic research and technology.
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Affiliation(s)
- Titilayo Ilori
- Division of Nephrology, Boston University School of Medicine, Boston, MA
| | - Andreia Watanabe
- Division of Molecular Medicine, Department of Pediatrics, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Kar-Hui Ng
- Department of Pediatrics, Yong Loo Lin School of Medicine, Singapore
| | - Adaobi Solarin
- Department of Pediatrics and Child Health, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Aditi Sinha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rasheed Gbadegesin
- Division of Nephrology, Department of Pediatrics, Duke University School of Medicine, Durham, NC.
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Solarin A, Oladimeji A, Akinyosoye G. POS-657 PAEDIATRIC HAEMODIALYSIS: A FIVE YEAR EXPERIENCE IN A TERTIARY CENTRE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Solarin A, Oguokiri E, Disu E, Njokanma F. POS-074 SERUM NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN, EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN ASPHYXIATED TERM NEONATES AT LAGOS STATE UNIVERSITY TEACHING HOSPITAL. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Esezobor C, Ademola AD, Adetunji AE, Anigilaje EA, Batte A, Jiya-Bello FN, Furia FF, Muoneke U, McCulloch M, Nourse P, Obiagwu P, Odetunde O, Okyere P, Solarin A, Tannor EK, Noone D, Gbadegesin R, Parekh RS. Management of idiopathic childhood nephrotic syndrome in sub-Saharan Africa: Ibadan consensus statement. Kidney Int 2021; 99:59-67. [PMID: 32866504 PMCID: PMC10069409 DOI: 10.1016/j.kint.2020.07.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/24/2020] [Accepted: 07/17/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Christopher Esezobor
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Adebowale D Ademola
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Adewale E Adetunji
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Emmanuel A Anigilaje
- Nephrology Unit, Department of Pediatrics, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Anthony Batte
- Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Francis F Furia
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Uzoamaka Muoneke
- Department of Pediatrics, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | | | - Peter Nourse
- Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | | | | | - Perditer Okyere
- Department of Internal Medicine, Komfo Anokye Teaching Hospital, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Adaobi Solarin
- Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | | | - Damien Noone
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rasheed Gbadegesin
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rulan S Parekh
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Jia X, Yamamura T, Gbadegesin R, McNulty MT, Song K, Nagano C, Hitomi Y, Lee D, Aiba Y, Khor SS, Ueno K, Kawai Y, Nagasaki M, Noiri E, Horinouchi T, Kaito H, Hamada R, Okamoto T, Kamei K, Kaku Y, Fujimaru R, Tanaka R, Shima Y, Baek J, Kang HG, Ha IS, Han KH, Yang EM, Abeyagunawardena A, Lane B, Chryst-Stangl M, Esezobor C, Solarin A, Dossier C, Deschênes G, Vivarelli M, Debiec H, Ishikura K, Matsuo M, Nozu K, Ronco P, Cheong HI, Sampson MG, Tokunaga K, Iijima K. Common risk variants in NPHS1 and TNFSF15 are associated with childhood steroid-sensitive nephrotic syndrome. Kidney Int 2020; 98:1308-1322. [PMID: 32554042 DOI: 10.1016/j.kint.2020.05.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/23/2020] [Accepted: 05/01/2020] [Indexed: 12/16/2022]
Abstract
To understand the genetics of steroid-sensitive nephrotic syndrome (SSNS), we conducted a genome-wide association study in 987 childhood SSNS patients and 3,206 healthy controls with Japanese ancestry. Beyond known associations in the HLA-DR/DQ region, common variants in NPHS1-KIRREL2 (rs56117924, P=4.94E-20, odds ratio (OR) =1.90) and TNFSF15 (rs6478109, P=2.54E-8, OR=0.72) regions achieved genome-wide significance and were replicated in Korean, South Asian and African populations. Trans-ethnic meta-analyses including Japanese, Korean, South Asian, African, European, Hispanic and Maghrebian populations confirmed the significant associations of variants in NPHS1-KIRREL2 (Pmeta=6.71E-28, OR=1.88) and TNFSF15 (Pmeta=5.40E-11, OR=1.33) loci. Analysis of the NPHS1 risk alleles with glomerular NPHS1 mRNA expression from the same person revealed allele specific expression with significantly lower expression of the transcript derived from the risk haplotype (Wilcox test p=9.3E-4). Because rare pathogenic variants in NPHS1 cause congenital nephrotic syndrome of the Finnish type (CNSF), the present study provides further evidence that variation along the allele frequency spectrum in the same gene can cause or contribute to both a rare monogenic disease (CNSF) and a more complex, polygenic disease (SSNS).
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Affiliation(s)
- Xiaoyuan Jia
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomohiko Yamamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rasheed Gbadegesin
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Michelle T McNulty
- Department of Medicine-Nephrology, Boston Children's Hospital, Boston, Massachussetts, USA; Medical and Population Genetics, Broad Institute, Cambridge, Massachussetts, USA
| | - Kyuyong Song
- Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, Seoul, Korea
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuki Hitomi
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Dongwon Lee
- Department of Medicine-Nephrology, Boston Children's Hospital, Boston, Massachussetts, USA; Medical and Population Genetics, Broad Institute, Cambridge, Massachussetts, USA; Harvard Medical School, Boston, Massachussetts, USA
| | - Yoshihiro Aiba
- Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuko Ueno
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Kawai
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masao Nagasaki
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eisei Noiri
- Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko Horinouchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Kaito
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Riku Hamada
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshitsugu Kaku
- Department of Nephrology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Rika Fujimaru
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | - Ryojiro Tanaka
- Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yuko Shima
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | | | - Jiwon Baek
- Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Il-Soo Ha
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Kyoung Hee Han
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Eun Mi Yang
- Department of Pediatrics, Chonnam National University Children's Hospital, Gwangju, Korea
| | | | - Asiri Abeyagunawardena
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Brandon Lane
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Megan Chryst-Stangl
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher Esezobor
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Adaobi Solarin
- Department of Pediatrics, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | | | - Claire Dossier
- Department of Paediatric Nephrology, Public Assistance Hospital of Paris, Robert-Debré Hospital, Paris, France
| | - Georges Deschênes
- Center of Research on Inflammation, Institut National de la Santé et de la Recherche Médicale UMR 1149, University Sorbonne-Paris, Paris, France
| | | | - Marina Vivarelli
- Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Hanna Debiec
- Sorbonne University, INSERM UMR_S1155, and Nephrology Day Hospital, Department of Nephrology, Hôpital Tenon, Paris France
| | - Kenji Ishikura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Masafumi Matsuo
- Research Center for Locomotion Biology, Kobe Gakuin University, Kobe, Japan; KNC Department of Nucleic Acid Drug Discovery, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Pierre Ronco
- Sorbonne University, INSERM UMR_S1155, and Nephrology Day Hospital, Department of Nephrology, Hôpital Tenon, Paris France
| | - Hae Il Cheong
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Matthew G Sampson
- Department of Medicine-Nephrology, Boston Children's Hospital, Boston, Massachussetts, USA; Medical and Population Genetics, Broad Institute, Cambridge, Massachussetts, USA; Harvard Medical School, Boston, Massachussetts, USA
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
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Madise-Wobo AD, Gbelee OH, Solarin A, Animasahun BA, Njokanma OF. Serum cystatin C levels in Healthy Nigerian neonates: Is there a need for normative values in Nigerian babies? Saudi J Kidney Dis Transpl 2019; 28:1247-1255. [PMID: 29265035 DOI: 10.4103/1319-2442.220881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cystatin C is an endogenous marker of renal function. Normal reference values have been documented in neonates outside Africa, but no study has been documented in African neonates. With reports that race may affect serum cystatin C values, this study was carried out to generate normal values in apparently healthy term neonates at birth and three days of life neonates in Nigeria. This was a hospital-based prospective study. A cohort of 120 apparently healthy term neonates were recruited at birth. Serum cystatin C was measured from the cord blood at birth and venous blood when they were three days old using enzyme-linked immunosorbent assay (ELISA) method. The mean serum cystatin C values for cord blood and 3rd day venous samples were 1.67 ± 0.52 mg/L and 1.62 ± 0.52 mg/L, respectively (P = 0.87). The cord blood and 3rd day serum cystatin C values for males were 1.67 ± 0.47 mg/L and 1.68 ± 0.51 mg/L, respectively (P = 0.77) and the values for females were 1.68 ± 0.56 mg/L and 1.58 ± 0.52 mg/L, respectively (P = 07.22). The serum cystatin C levels were similar among the different birth weight groups and gestational age (P >0.05). The cord blood and 3rd day serum cystatin C values were similar. Serum cystatin C values were independent of gender and birth weight of neonates. The values of serum cystatin C in Nigerian neonates were comparable to that reported for neonates in other regions of the world. It is recommended that ELISA technique may be reliably used to measure serum cystatin C levels in neonates.
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Affiliation(s)
| | - Olusegun H Gbelee
- Department of Pediatrics, Lagos State University Teaching Hospital; Department of Pediatrics and Child Health, Lagos State University College of Medicine, Ikeja Lagos, Nigeria
| | - Adaobi Solarin
- Department of Pediatrics, Lagos State University Teaching Hospital, Ikeja Lagos, Nigeria
| | - Barakat A Animasahun
- Department of Pediatrics, Lagos State University Teaching Hospital; Department of Pediatrics and Child Health, Lagos State University College of Medicine, Ikeja Lagos, Nigeria
| | - Olisamedua F Njokanma
- Department of Pediatrics, Lagos State University Teaching Hospital; Department of Pediatrics and Child Health, Lagos State University College of Medicine, Ikeja Lagos, Nigeria
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Solarin A, Adekunle M, Gbelee H, Animashaun A, Njokanma F. SAT-316 HEALTH RELATED QUALITY OF LIFE OF CHILDREN WITH NEPHROTIC SYNDROME IN LAGOS NIGERIA. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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9
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Madise-Wobo AD, Disu EA, Gbelee OH, Solarin A, Animasahun BA. Estimated glomerular filtration rate in apparently healthy term neonates in Nigeria. AJN 2018. [DOI: 10.21804/21-1-2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Varner JD, Chryst-Stangl M, Esezobor CI, Solarin A, Wu G, Lane B, Hall G, Abeyagunawardena A, Matory A, Hunley TE, Lin JJ, Howell D, Gbadegesin R. Genetic Testing for Steroid-Resistant-Nephrotic Syndrome in an Outbred Population. Front Pediatr 2018; 6:307. [PMID: 30406062 PMCID: PMC6204400 DOI: 10.3389/fped.2018.00307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Steroid-resistant nephrotic syndrome (SRNS) is a leading cause of end-stage kidney disease in children and young adults. Despite advances in genomic science that have led to the discovery of >50 monogenic causes of SRNS, there are no clear guidelines for genetic testing in clinical practice. Methods: Using high throughput sequencing, we evaluated 492 individuals from 181 families for mutations in 40 known SRNS genes. Causative mutations were defined as missense, truncating, and obligatory splice site variants with a minor allele frequency <1% in controls. Non-synonymous variants were considered pathogenic if determined to be deleterious by at least two in silico models. We further evaluated for differences in age at disease onset, family history of SRNS or chronic kidney disease, race, sex, renal biopsy findings, and extra-renal manifestations in subgroups with and without disease causing variants. Results: We identified causative variants in 40 of 181 families (22.1%) with SRNS. Variants in INF2, COL4A3, and WT1 were the most common, accounting for over half of all causative variants. Causative variants were identified in 34 of 86 families (39.5%) with familial disease and 6 of 95 individuals (6.3%) with sporadic disease (χ2 p < 0.00001). Family history was the only significant clinical predictor of genetic SRNS. Conclusion: We identified causative mutations in almost 40% of all families with hereditary SRNS and 6% of individuals with sporadic disease, making family history the single most important clinical predictors of monogenic SRNS. We recommend genetic testing in all patients with SRNS and a positive family history, but only selective testing in those with sporadic disease.
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Affiliation(s)
- Jennifer D Varner
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Megan Chryst-Stangl
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | | | - Adaobi Solarin
- Department of Pediatrics, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Guanghong Wu
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Brandon Lane
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Gentzon Hall
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | | | - Ayo Matory
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States
| | - Tracy E Hunley
- Division of Nephrology, Department of Pediatrics, Vanderbilt University, Nashville, TN, United States
| | - Jen Jar Lin
- Department of Pediatrics, Wake Forest Baptist Medical Center, Winston Salem, NC, United States
| | - David Howell
- Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Rasheed Gbadegesin
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
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11
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Adeyemo A, Esezobor C, Solarin A, Abeyagunawardena A, Kari JA, El Desoky S, Greenbaum LA, Kamel M, Kallash M, Silva C, Young A, Hunley TE, de Jesus-Gonzalez N, Srivastava T, Gbadegesin R. HLA-DQA1 and APOL1 as Risk Loci for Childhood-Onset Steroid-Sensitive and Steroid-Resistant Nephrotic Syndrome. Am J Kidney Dis 2017; 71:399-406. [PMID: 29277510 DOI: 10.1053/j.ajkd.2017.10.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/05/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Few data exist for the genetic variants underlying the risk for steroid-sensitive nephrotic syndrome (SSNS) in children. The objectives of this study were to evaluate HLA-DQA1 and APOL1 variants as risk factors for SSNS in African American children and use classic HLA antigen types and amino acid inference to refine the HLA-DQA1 association. STUDY DESIGN Case-control study. SETTING & PARTICIPANTS African American children with SSNS or steroid-resistant nephrotic syndrome (SRNS) were enrolled from Duke University and centers participating in the Midwest Pediatric Nephrology Consortium. FACTOR Genetic variants in HLA-DQA1 (C34Y [rs1129740]; F41S [rs1071630]) and APOL1 high-risk alleles. OUTCOMES SSNS and SRNS. MEASUREMENTS Direct sequencing for the HLA-DQA1 and APOL1 variants in 115 African American children (65 with SSNS and 50 with SRNS). Imputation of classic HLA alleles and amino acids was done in 363 South Asian children. RESULTS The 2 HLA-DQA1 variants were significantly associated with SSNS in African American children (C34Y: P=5.7 × 10-11; OR, 3.53; 95% CI, 2.33-5.42; F41S: P=1.2 × 10-13; OR, 4.08; 95% CI, 2.70-6.28), but not with SRNS (C34Y: P=0.6; F41S: P=0.2). APOL1 high-risk variants were not associated with SSNS (P=0.5) but showed significant associations with SRNS (P=1.04 × 10-7; OR, 4.17; 95% CI, 2.23-7.64). HLA-DQA1*0201, HLA-DQB1*0201, and HLA-DRB1*0701 were the classic HLA alleles with the most significant associations with SSNS risk. The most significantly associated amino acid positions were HLA-DQα1 56 and 76 (both P=2.8 × 10-7). Conditional analysis revealed that these variants most likely account for the observed association. LIMITATIONS Modest sample size and limited statistical power to detect small to moderate effect sizes. Children studied may not be representative of all African American children in the United States. CONCLUSIONS HLA-DQA1 is a risk locus for SSNS, but not SRNS, in African American children, consistent with its role in SSNS risk in children of European, Asian, and African ancestries. There is little evidence of a significant role for the APOL1 high-risk alleles in childhood SSNS in African American children. Refinement of the HLA-DQA1 association identified the critical classic HLA antigen types and amino acids of the HLA-DQ α1 molecule.
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Affiliation(s)
- Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD.
| | - Christopher Esezobor
- Department of Pediatrics, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Adaobi Solarin
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | | | - Jameela A Kari
- Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sherif El Desoky
- Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Larry A Greenbaum
- Division of Pediatric Nephrology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA
| | - Margret Kamel
- Division of Pediatric Nephrology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA
| | - Mahmoud Kallash
- Department of Pediatrics, State University of New York, Buffalo, NY
| | - Cynthia Silva
- Division of Nephrology, Connecticut Children's Hospital, Hartford, CT
| | - Alex Young
- Division of Nephrology, Department of Pediatrics, and Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC
| | - Tracey E Hunley
- Division of Nephrology, Department of Pediatrics, Vanderbilt University, Nashville, TN
| | - Nilka de Jesus-Gonzalez
- Department of Pediatrics, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Tarak Srivastava
- Department of Nephrology, Children Mercy Hospital, Kansas City, MO
| | - Rasheed Gbadegesin
- Division of Nephrology, Department of Pediatrics, and Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC.
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Animasahun BA, Gbelee OH, Solarin A, Ikuerowo AOA, Raji AM, Ubuane P, Kingsley EO, Njokanma FO. Eosinophilic meningitis in a 10-year old nigerian boy: a case report. Afr J Infect Dis 2013; 7:11-3. [PMID: 24381722 PMCID: PMC3647521 DOI: 10.4314/ajid.v7i1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Eosinophilic meningitis is rare, commonly caused by invasion of the central nervous system by helminthes. The present case is that of a 10-year-old boy who presented with history of generalized pruritus not associated with skin eruptions, followed by pain and weakness of the extremities and loss of consciousness. Patient did not receive BCG vaccination. Initial clinical evaluation was suggestive of tuberculous meningitis but cerebrospinal fluid analysis revealed eosinophilic meningitis. Patient made remarkable improvement with treatment with no sequel.
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Affiliation(s)
- B Adeola Animasahun
- Department of Paediatrics and Child Health, Lagos State
University College of Medicine Ikeja, Lagos, Nigeria
| | - Olugbenga H Gbelee
- Department of Paediatrics and Child Health, Lagos State
University College of Medicine Ikeja, Lagos, Nigeria
| | - Adaobi Solarin
- Department of Paediatrics and Child Health, Reddington
Multispecialist Hospital Ikeja, Lagos, Nigeria
| | - Ajibike OA Ikuerowo
- Department of Paediatrics, Lagos State University Teaching
Hospital Ikeja, Lagos, Nigeria
| | - Adeola M Raji
- Department of Microbiology and Parasitology, Lagos State
University College of Medicine Ikeja, Lagos, Nigeria
| | - Peter Ubuane
- Department of Paediatrics, Lagos State University Teaching
Hospital Ikeja, Lagos, Nigeria
| | - EO Kingsley
- Department of Microbiology and Parasitology, Lagos State
University College of Medicine Ikeja, Lagos, Nigeria
| | - Fidelis O Njokanma
- Department of Paediatrics and Child Health, Lagos State
University College of Medicine Ikeja, Lagos, Nigeria
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