title: Apolipoprotein L1 and Chronic Kidney Disease Risk in Young Potential Living Kidney Donors.
abstract: The aim of this study was to develop a novel chronic kidney disease (CKD) risk prediction tool for young potential living kidney donors.
  
  
  
  Living kidney donor selection practices have evolved from examining individual risk factors to a risk calculator incorporating multiple characteristics. Owing to limited long-term data and lack of genetic information, current risk tools lack precision among young potential living kidney donors, particularly African Americans (AAs).
  
  
  
  We identified a cohort of young adults (18-30 years) with no absolute contraindication to kidney donation from the longitudinal cohort study Coronary Artery Risk Development in Young Adults. Risk associations for CKD (estimated glomerular filtration rate <60 mL/min/1.73 m) were identified and assigned weighted points to calculate risk scores.
  
  
  
  A total of 3438 healthy adults were identified [mean age 24.8 years; 48.3% AA; median follow-up 24.9 years (interquartile range: 24.5-25.2)]. For 18-year olds, 25-year projected CKD risk varied by ethnicity and sex even without baseline clinical and genetic abnormalities; risk was 0.30% for European American (EA) women, 0.52% for EA men, 0.52% for AA women, 0.90% for AA men. Among 18-year-old AAs with apolipoprotein L1 gene (APOL1) renal-risk variants without baseline abnormalities, 25-year risk significantly increased: 1.46% for women and 2.53% for men; among those with 2 APOL1 renal-risk variants and baseline abnormalities, 25-year risk was higher: 2.53% to 6.23% for women and 4.35% to 10.58% for men.
  
  
  
  Young AAs were at highest risk for CKD, and APOL1 renal-risk variants drove some of this risk. Understanding the genetic profile of young AA potential living kidney donors in the context of baseline health characteristics may help to inform candidate selection and counseling.
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Jayme E
authors.initials: JE
authors.lastname: Locke
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Sawinski
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Rhiannon D
authors.initials: RD
authors.lastname: Reed
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Brittany
authors.initials: B
authors.lastname: Shelton
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Paul A
authors.initials: PA
authors.lastname: MacLennan
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Shikha
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Roslyn B
authors.initials: RB
authors.lastname: Mannon
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Robert
authors.initials: R
authors.lastname: Gaston
authors.affiliation: Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Julian
authors.affiliation: Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: John J
authors.initials: JJ
authors.lastname: Carr
authors.affiliation: Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: James G
authors.initials: JG
authors.lastname: Terry
authors.affiliation: University of Alabama at Birmingham School of Public Health, Birmingham, AL.
authors.forename: Meredith
authors.initials: M
authors.lastname: Kilgore
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Allan B
authors.initials: AB
authors.lastname: Massie
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
authors.affiliation: University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000235:genetics; D000075944:Apolipoprotein L1 / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000235:genetics; D018570:Risk Assessment / Q000379:methods*; D044465:White People / Q000235:genetics; D055815:Young Adult
chemical_list: C108666:APOL1 protein, human; D000075944:Apolipoprotein L1