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APOL1 Nephropathy Risk Alleles and Mortality in African American Adults: A Cohort Study

  1. Author:
    Gutiérrez, Orlando M
    Irvin, Marguerite R
    Zakai, Neil A
    Naik, Rakhi P
    Chaudhary, Ninad S
    Estrella, Michelle M
    Limou, Sophie
    Judd, Suzanne E
    Cushman, Mary
    Kopp, Jeffrey B
    Winkler,Cheryl

  2. Author Address

    Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL., Departments of Medicine and Pathology, Robert Larner College of Medicine, University of Vermont, Burlington, VT., Department of Medicine, Division of Hematology, Johns Hopkins Medicine, Baltimore, MD., Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, CA; San Francisco VA Medical Center, San Francisco, CA., University of Nantes, Nantes, France., University of Nantes, Nantes, France; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL., Departments of Medicine and Pathology, Robert Larner College of Medicine, University of Vermont, Burlington, VT; Departments of Medicine and Pathology, Departments of Laboratory Medicine, Robert Larner College of Medicine, University of Vermont, Burlington, VT., National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD., Basic Research Program, Frederick National Laboratory for Cancer Research, Frederick, MD. Electronic address: winklerc@mail.nih.gov.,
    1. Year: 2020
    2. Date: Jan
    3. Epub Date: 2019 09 26
  2. Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation
    1. 75
    2. 1
    3. Pages: 54-60
  4. Type of Article: Article
  5. ISSN: 0272-6386
  1. Abstract:

    RATIONALE & OBJECTIVE: APOL1 nephropathy risk alleles are associated with the development of chronic kidney disease (CKD) in African Americans. Although CKD is an established risk factor for mortality, associations of APOL1 risk alleles with mortality are uncertain. STUDY DESIGN: Prospective cohort. SETTINGS & PARTICIPANTS: 10,380 African American and 17,485 white American participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. EXPOSURES: APOL1 nephropathy risk alleles. OUTCOMES: All-cause and cause-specific mortality. ANALYTICAL APPROACH: Cox proportional hazards models were used to examine the association of APOL1 high-risk genotypes (2 risk alleles) versus APOL1 low-risk genotypes (0/1 risk allele) with all-cause and cause-specific mortality in African Americans and examine the risk for all-cause mortality in African Americans with high-risk genotypes versus African Americans with low-risk genotypes and white Americans. RESULTS: APOL1 high-risk participants were younger and had a higher prevalence of albuminuria than low-risk participants. There was no statistically significant association of APOL1 high- versus low-risk genotypes with all-cause mortality in models adjusted for sociodemographic variables, comorbid conditions, and kidney function (HR, 0.88; 95% CI, 0.77-1.01). After further adjustment for genetic ancestry in a subset with available data, a statistically significant association emerged (HR, 0.81; 95% CI, 0.69-0.96). Associations differed by CKD status (Pinteraction=0.04), with African Americans with high-risk genotypes having lower risk for mortality than those with low-risk genotypes in fully adjusted models (HR, 0.78; 95% CI, 0.62-0.99) among those with CKD, but not those without CKD (HR, 0.84; 95% CI, 0.66-1.05). Compared with white Americans, African Americans with high-risk genotypes had a similar rate of mortality, whereas African Americans with low-risk genotypes had a higher rate of mortality (HR, 1.07; 95% CI, 1.00-1.14) in fully adjusted models. LIMITATIONS: Lack of follow-up measures of kidney function. CONCLUSIONS: African Americans with high-risk APOL1 genotypes had lower mortality than those with low-risk genotypes in multivariable-adjusted models including genetic ancestry. Published by Elsevier Inc.

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External Sources

  1. View Full Text
  2. DOI: 10.1053/j.ajkd.2019.05.027
  3. PMID: 31563468
  4. View record in Web of Science®
  5. WOS: 000503198700011
  6. PII : S0272-6386(19)30850-9

Library Notes

  1. Fiscal Year: FY2019-2020
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