title: Genetic variation in APOL1 associates with younger age at hemodialysis initiation.
abstract: African Americans have a markedly higher incidence of ESRD compared with other racial groups. Two variants in the APOL1 gene, to date observed only among individuals of recent African ancestry, associate with increased risk for renal disease among African Americans. Here, we investigated whether these risk alleles also associate with age at initiation of chronic hemodialysis. We performed a cross-sectional study of 407 nondiabetic African Americans with ESRD who participated in the Accelerated Mortality on Renal Replacement (ArMORR) study, a prospective cohort of incident chronic hemodialysis patients. African Americans carrying two copies of the G1 risk allele initiated chronic hemodialysis at a mean age of 49.0 ± 14.9 years, which was significantly younger than both subjects with one copy of the G1 allele (55.9 ± 16.7 years; P = 0.014) and subjects without either risk allele (61.8 ± 17.1 years; P = 6.2 × 10(-7)). The association between the presence of the G1 allele and age at initiation of hemodialysis remained statistically significant after adjusting for sociodemographic and other potential confounders. We did not detect an association between the G2 risk allele and age at initiation of hemodialysis, but the sample size was limited. In conclusion, genetic variations in APOL1 identify African Americans that initiate chronic hemodialysis at a younger age. Early interventions to prevent progression of kidney disease may benefit this high-risk population.
authors: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Zahra
authors: Z
authors: Kanji
authors: Camille E
authors: CE
authors: Powe
authors: Julia B
authors: JB
authors: Wenger
authors: Chunmei
authors: C
authors: Huang
authors: Elizabeth
authors: E
authors: Ankers
authors: Dorothy A
authors: DA
authors: Sullivan
authors: Gina
authors: G
authors: Collerone
authors: Neil R
authors: NR
authors: Powe
authors: Marcello
authors: M
authors: Tonelli
authors: Ishir
authors: I
authors: Bhan
authors: Andrea J
authors: AJ
authors: Bernhardy
authors: Salvatore
authors: S
authors: Dibartolo
authors: David
authors: D
authors: Friedman
authors: Giulio
authors: G
authors: Genovese
authors: Martin R
authors: MR
authors: Pollak
authors: Ravi
authors: R
authors: Thadhani
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000235:genetics* / Q000706:statistics & numerical data; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000075944:Apolipoprotein L1; D001053:Apolipoproteins / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000235:genetics* / Q000628:therapy*; D008075:Lipoproteins, HDL / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: C108666:APOL1 protein, human; D000075944:Apolipoprotein L1; D001053:Apolipoproteins; D008075:Lipoproteins, HDL