Diabetes & Kidney Disease
The centre currently focuses on kidney disease in the H3Africa Kidney Disease Research Network. Its primary goal is to conduct genomics, clinical and translational research on the most prevalent forms of chronic kidney disease (CKD), expand and support a well-trained cadre of African researchers and physician scientists to conduct CKD research.
In 2019, the network focused on a cohort study that was initiated in 2018. This research was formulated to identify genetic risk factors of CKD among Africans. Estimates indicate more than three million African-Americans and greater than 50 million African Blacks have CKD due to clinically defined nephropathies (from hypertension, diabetes mellitus, sickle disease, etc.) and glomerula nephritis. A significant fraction of these will progress to end-stage-renal disease (ESRD) which is a harbinger of imminent death in the African setting due to the scarcity of dialysis or kidney transplantation.
This H3Africa Kidney Disease Research Network cohort study is the first adequately powered prospective cohort study to both identify the genetic determinants and characterize the phenotype for kidney disease progression in Sub Sahara-Africa. The Aims of the research are:
• To evaluate the independent contribution of risk variants in the APOL1 genes to the progression of clinically defined nephropathies among 2,500 HIV-negative African Blacks.
• To elucidate gene-environment interactions (G-E) between APOL1 variants and infections) on glomerular disease and evaluate the incidence, histopathological spectrum and the natural history of biopsy-confirmed glomerular diseases in 1,500 HIV-negative African Blacks from various SSA countries and regions.
The impact of this research is that it will enable us to: (1) know how APOL1 risk variants impact kidney disease progression; (2) identify the modifiable risk factors for kidney disease progression; (3) determine how APOL1 renal variants impact the risks and outcomes of non-HIV infection-associated glomerular nepheritis; (4) obtain novel insights into the histopathological spectrum and natural history of glomerular diseases in Blacks; and (5) create a research data and specimen repository that would serve as a platform for basic research, translational studies and therapeutic trials of kidney disease in Blacks.
As of December 2019, the following achievements have been made:
• The total recruitment for Accra and Kumasi is 587
• Renal biopsies have been performed on 76 participants
• DNA have been isolated, quantified and stored, and have undergone quality control assays; the amelogenin and SRY Y assays for gender determination, Alu1 repeat, hemoglobin S and C determination, using the initial polymerase chain reaction and Ligase detection reaction based amplification.
In another collaborative study involving 12 academic medical centres/university teaching hospitals in four African countries (Cameroon-1; Ghana-2; Nigeria-7; South Africa-1; and Tanzania-1), the following achievements were made in 2019 with respect to recruitment:
• Sickle Cell Disease- 197
• C and L-HIV- 8
• Nephrotic syndrome- 23
Our ongoing plans are to ensure ethical recruitment and good quality control of data acquisition and laboratory studies.