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<p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2011-10-31T00:00:00-04:00" class="date-display-single">October 31, 2011</span></p><div class='syndicate'><h1>Pinpointing Kidney Disease Risk in African Americans</h1><div class="media-float-right"><div class="ds-1col file file-image file-image-jpeg view-mode-floated_media clearfix">
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</div><p>Variants in the <em>APOL1</em> gene account for the increased risk of kidney disease among African Americans, according to a new report. The finding may lead to screening tests and earlier treatment, although further research is required.</p>
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<p>When a person has kidney disease, the kidneys are unable to fully remove waste products and extra water from the blood. Long-term kidney disease hits the African American community especially hard, with rates up to 4 times higher than in European Americans.</p>
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<p>In 2010, several NIH-funded research teams linked kidney disease risk to variants in a gene called <em>APOL1</em>. About 12% of African Americans have 2 copies of the <em>APOL1</em> variants that increase the risk of kidney disease. These variants weren't found in people from other continents.</p>
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<p>A research team led by Dr. Jeffrey Kopp at NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and Dr. Cheryl Winkler of NIH's National Cancer Institute (NCI) set out to do a comprehensive analysis of <em>APOL1</em> variation in both African Americans and European Americans. The researchers studied a common kidney disease called focal segmental glomerulosclerosis (FSGS). FSGS often progresses to end-stage kidney disease and the need for dialysis or a kidney transplant. The researchers studied patients who came to the NIH Clinical Center and other collaborating medical centers.</p>
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<p>In the October 13, 2011, online edition of the <em>Journal of the American Society of Nephrology</em>, the team reported that African Americans with 2 copies of the <em>APOL1</em> variants have about a 4% lifetime risk of developing FSGS. Those with the variants who develop kidney disease tend to do so at younger ages than other FSGS patients.</p>
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<p>African Americans who have HIV and 2 copies of the <em>APOL1</em> variants also have a higher risk of developing HIV-associated nephropathy (HIVAN) — a type of kidney disease that develops in some people with HIV. People who fall into this category and are not being treated with anti-viral therapy have a 50% risk for developing HIVAN.</p>
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<p>“These findings explain nearly all of the excess risk of non-diabetic kidney failure in African Americans. African Americans with no variant or 1 variant have about the same risk of end-stage kidney disease as their white counterparts,” Winkler says. “People with 2 <em>APOL1</em> variants have greatly increased risk of particular kidney diseases — by 17- to 30-fold.”</p>
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<p>“In the future, knowing that you have these gene variants and are at increased risk of developing kidney disease may tell you when to start screening for the disease and how to choose therapy,” Kopp says.</p>
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<p>FSGS patients with 2 <em>APOL1</em> variants respond as well to steroid treatments as those who don't have the variants, the researchers found. And anti-viral therapy appears fairly effective at preventing HIVAN. However, Kopp cautions that more research is needed to find out whether early genetic testing in the African American population would make a difference in eventual outcomes.</p>
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</div><h2 class="label-above">Related Links</h2><ul class="spaced print-urls"><li><a href="http://www2.niddk.nih.gov/NIDDKLabs/Glomerular_Disease_Primer/" target="_top">Glomerular Disease Primer</a></li><li><a href="http://nkdep.nih.gov/" target="_top">National Kidney Disease Education Program</a></li><li><a href="http://www.nih.gov/researchmatters/august2010/08022010gene.htm" target="_top">Gene Tied to Kidney Disease, Sleeping Sickness in African Americans</a></li><li><a href="http://www.nih.gov/researchmatters/september2008/09222008kidney.htm" target="_top">Gene Variations Linked to Kidney Disease in African Americans</a></li></ul>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/complete-wiring-map-adult-fruit-fly-brain">Complete wiring map of an adult fruit fly brain</a></p>
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<p><strong><em>NIH Research Matters </em></strong>is a weekly update of NIH research highlights reviewed by NIH’s experts. It's published by the <a href="/institutes-nih/nih-office-director/office-communications-public-liaison">Office of Communications and Public Liaison</a> in the <a href="/institutes-nih/nih-office-director">NIH Office of the Director</a>.</p>
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