The role of interleukin-1 beta as an early biomarker for renal dysfunction in Egyptian sickle cell disease patients

Background

Sickle cell nephropathy is a recognized complication increasingly seen in young individuals with sickle cell disease (SCD). The typical progression of glomerular disease is thought to involve hyperfiltration and albuminuria, eventually leading to a decline in glomerular filtration rates and ultimately end-stage renal disease (ESRD). This study sought to investigate the relationship between urinary interleukin-1 beta (IL-1β), a marker of inflammation, and existing biomarkers of renal damage in SCD patients. The goal was to identify IL-1β as a novel, early diagnostic biomarker for sickle nephropathy.

Patients and methods

This case-control study enrolled forty-six patients (both genders, aged 18–40 years) with sickle cell disease and forty-six healthy controls. All patients were subjected to the following: A complete medical history, physical examination, and laboratory investigation including a complete blood analysis, blood chemistry (which included kidney function tests and liver function, serum ferritin, urinalysis, hepatitis B surface antigen and hepatitis C antibody, estimated GFR, urinary IL-1 beta using the ELISA technique, and urinary albumin/creatinine ratio). These measurements were taken for both the case and control groups.

Results

The mean estimated glomerular filtration rate (eGFR) level showed a statistically significant increase in SCD patients. The median value of the albumin/creatinine ratio level was statistically different between cases and controls. The median value of urinary IL-1 beta level was statistically different between cases and controls. Assessment of correlations between urinary IL-1 beta and eGFR revealed a statistically significant negative correlation between them, while assessment of the correlation between urinary IL-1 beta and the urinary albumin/creatinine ratio revealed a statistically significant positive correlation between them in sickle cell patients.

Conclusion

In this study, significant renal hyperfiltration, a high frequency of albuminuria, and elevated urine IL-1β levels are all present in Egyptian adults with sickle cell disease. Urinary IL-1β, albuminuria, and eGFR are strongly correlated, highlighting the crucial role of inflammation in sickle cell nephropathy pathogenesis. A promising non-invasive biomarker for early renal injury and disease progression in sickle cell disease (SCD) may be urinary IL-1β.