Apolipoprotein-1 risk variants and associated kidney phenotypes in an adult HIV cohort in Nigeria

APOL1 Renal Risk Variants and Sickle Cell Trait Associations With Reduced Kidney Function in a Large Congolese Population-Based Study

“… 36 For example, Wudil et al. 37 in Nigeria reported APOL1 HR frequency ranging from ∼2% to 50% depending on ethnicity. This calls for further large-scale studies across different provinces (26 provinces) and ethnic groups of the DRC (>250 ethnic groups) to fully capture the epidemiology and renal risk associated with APOL1 genetic variants.…”

Health inequities and the inappropriate use of race in nephrology

“…Thus, the presence of these genetic variants in some individuals of West African descent should not be used to make generalizations about all people who may be labelled as Black around the world. In fact, even across different ethnic groups in Nigeria, the prevalence of high-risk APOL1 variants varies from 2.1–49.1% indicating massive heterogeneity even within one of the regions with greatest prevalence 107 . Precision medicine in nephrology remains an area of development and substantial additional work is needed to further understand the direct link between genetic markers such as APOL1 and CKD across populations globally 108 .…”

Genetic Variants of APOL1 Are Major Determinants of Kidney Failure in People of African Ancestry With HIV

“…Two recent studies from Nigeria, in which most participants had well-controlled HIV, found a relatively weak (OR 2) association between APOL1 high-risk genotypes and CKD (with or without renal impairment) or albuminuria. 23 , 27 The large proportion of participants with ESKD among those with eGFR <60 ml/min per 1.73 m 2 in our study may have contributed to the stronger association between APOL1 high-risk genotypes and renal impairment. A previous study in African Americans reported no impact of APOL1 status on the rate of progression to kidney failure requiring RRT in people who had been diagnosed with HIVAN.…”

“…Previous studies in adult populations of African Americans, Nigerians, and South Africans with HIV have also reported associations between APOL1 high-risk genotypes and FSGS, 22 albuminuria, 23 , 24 proteinuria, decline in eGFR, 25 eGFR <60 ml/min per 1.73 m 2 , 26 and CKD, 27 and raised the possibility that individuals with a single APOL1 variant may be at increased risk of developing kidney disease 17 , 26 and that the G1 variant may pose greater renal risk than the G2 variant. 12 , 17 Although participants with kidney failure (ESKD) were included in some of these studies, the association between APOL1 variants and ESKD has not been studied in people with HIV, and the burden of ESKD that is attributable to APOL1 variants remains unknown, particularly in geographically diverse African populations.…”