26 Acute phase reactants as predictors of chronic kidney disease incidence in Africans: the population-based prospective RODAM cohort study

Abstract PTH 1: Determinants of Health Disease and Interventions 1, B307 (FCSH), September 3, 2025, 14:30 - 15:30 Aims Chronic kidney disease (CKD) and chronic inflammation are highly prevalent in African populations, yet their relationship remains understudied. We aimed to investigated whether acute phase reactants (C-reactive protein [CRP] and ferritin) as markers of inflammation predict CKD incidence seven years later in a Ghanaian population-based cohort. Methods Data from the prospective Research on Obesity and Diabetes among African Migrants (RODAM-Pros) cohort were analyzed, including participants living in rural and urban Ghana, and Ghanaian migrants in the Netherlands. Acute phase reactants were assessed between 2012 and 2015, while CKD incidence was assessed between 2019 and 2021 using the race-free CKD-EPI 2021 equation. Robust Poisson regression models were employed to assess associations, adjusting for various confounders. Interaction analyses explored whether identified effects were modified through age, sex, education, or geographical location. We also examined CRP associations by different cut-offs (<1 mg/l, 1.0 to 3.0 mg/l, and >3 mg/l; 10 mg/l), as well as the potential contribution of ferritin as an indicator of iron storage, independent of its role as an acute phase reactant. Results 1,435 participants were included. No significant associations were found between baseline CRP and CKD incidence seven years later. Baseline ferritin levels were positively associated with CKD incidence (adjusted Incidence rate ratio 1.19, 95% CI 1.04-1.02) seven years later. Baseline ferritin was independently associated with albuminuria (aIRR 1.22. 95% CI 1.06-1.01), but not with decreased eGFR (aIRR 1.01, 95% CI, 0.95-1.06). Age, sex, education and geographical location did not mediate ferritin-CKD relationship. We did not detect a contributing role of iron overload or iron deficiency in ferritin-CKD relationship. Conclusion Elevated ferritin levels but not CRP levels may predict future risk of CKD in Ghanaians. Multi-population prospective studies with multiple ferritin measurements are needed to better understand the links between ferritin and CKD in Africans.