Jeffrey Kopp, MD (National Institutes of Health) and his team studied 271 African American cases of FSGS and HIVAN, 168 European American cases, and 939 healthy individuals. African Americans with variants in both copies of the APOL1 gene had a greatly increased risk of developing FSGS and HIVAN. Approximately 13% of African Americans (more than 3.5 million individuals) carry two APOL1 gene variants, and these individuals have a 4% risk during their lifetime of developing FSGS; those with untreated HIV have a 50% risk during their lifetime of developing HIVAN. "We also found that APOL1-associated FSGS tended to arise at an earlier age and to progress to kidney failure more rapidly than non-APOL1-associated FSGS," said Dr. Kopp.
Martin Pollak, MD (Beth Israel Deaconess Medical Center) and his group looked to see if APOL1 gene variants confer risks for other types of kidney disease among 2,867 African Americans. Nondiabetic individuals with two APOL1 gene variants had a four-fold increased risk of developing chronic kidney disease over nondiabetics without the gene variants. (No increased risk occurred among diabetics.) "Our research shows that APOL1 variants explain the difference between the high rate of kidney disease in African Americans compared with European Americans," said Dr. Pollak.
Dr. Pollak also collaborated with Ravi Thadani, MD (Massachusetts General Hospital) and others to examine whether African Americans with APOL1 gene variants need dialysis to treat kidney failure at a younger age than those without the variants. Among 407 African Americans with kidney failure, individuals with two gene variants started dialysis at an average age of 49.0 years, compared with 55.9 years for those with one gene variant and 61.8 years for those with no variants. "We may be able to predict when Blacks with kidney disease will experience kidney failure well before it
|Contact: Adrienne Lea|
American Society of Nephrology