Cases in Precision Medicine: APOL1 and Genetic Testing in the Evaluation of Chronic Kidney Disease and Potential Transplant

Ann Intern Med. 2019 Nov 5;171(9):659-664. doi: 10.7326/M19-1389. Epub 2019 Oct 8.

Abstract

This article discusses potential indications for genetic testing in an African American patient with chronic kidney disease who is being evaluated for a kidney transplant. Two known risk variants in the APOL1 (apolipoprotein L1) gene predispose to kidney disease and are found almost exclusively in persons of African ancestry. APOL1 risk variants are considered, including whether clinicians should incorporate genetic testing in the screening process for living kidney donors. In addition to APOL1 testing, the role of diagnostic exome sequencing in evaluating potential transplant recipients and donors with a positive family history of kidney disease is discussed.

MeSH terms

  • Apolipoprotein L1 / genetics*
  • Black or African American / genetics
  • Genetic Testing* / methods
  • Humans
  • Kidney Transplantation* / methods
  • Precision Medicine / methods*
  • Renal Insufficiency, Chronic / genetics*
  • Renal Insufficiency, Chronic / surgery
  • Tissue Donors

Substances

  • APOL1 protein, human
  • Apolipoprotein L1