APOL1 Nephropathy: From Genetics to Clinical Applications

Clin J Am Soc Nephrol. 2021 Feb 8;16(2):294-303. doi: 10.2215/CJN.15161219. Epub 2020 Jul 2.

Abstract

Rates of many types of severe kidney disease are much higher in Black individuals than most other ethnic groups. Much of this disparity can now be attributed to genetic variants in the apoL1 (APOL1) gene found only in individuals with recent African ancestry. These variants greatly increase rates of hypertension-associated ESKD, FSGS, HIV-associated nephropathy, and other forms of nondiabetic kidney disease. We discuss the population genetics of APOL1 risk variants and the clinical spectrum of APOL1 nephropathy. We then consider clinical issues that arise for the practicing nephrologist caring for the patient who may have APOL1 kidney disease.

Keywords: APOL1; APOL1 protein; African Americans; Apolipoprotein L1; Focal Segmental; Genetics; Glomerulosclerosis; HIV-Associated Nephropathy; Kidney Genomics Series; Population; chronic kidney disease; diabetes mellitus; genetic kidney disease; human; hypertension; kidney.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Associated Nephropathy / genetics
  • Africa / epidemiology
  • Alleles
  • Apolipoprotein L1 / genetics*
  • Black People / genetics*
  • Black or African American
  • Diabetic Nephropathies / genetics
  • Genetic Variation
  • Glomerulosclerosis, Focal Segmental / genetics
  • Humans
  • Hypertension / complications
  • Kidney Diseases / ethnology*
  • Kidney Diseases / genetics*
  • Kidney Diseases / therapy
  • Kidney Failure, Chronic / genetics
  • Kidney Transplantation
  • Risk Factors

Substances

  • APOL1 protein, human
  • Apolipoprotein L1