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Clinical Research
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APOL1 Genotype and Renal Function of Black Living Donors

Mona D. Doshi, Mariella Ortigosa-Goggins, Amit X. Garg, Lihua Li, Emilio D. Poggio, Cheryl A. Winkler and Jeffrey B. Kopp
JASN April 2018, 29 (4) 1309-1316; DOI: https://doi.org/10.1681/ASN.2017060658
Mona D. Doshi
1Division of Nephrology, University of Michigan, Ann Arbor, Michigan;
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Mariella Ortigosa-Goggins
2Division of Nephrology, Miami Transplant Institute, University of Miami, Miami, Florida;
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Amit X. Garg
3Division of Nephrology, Western University, London, Ontario, Canada;
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Lihua Li
3Division of Nephrology, Western University, London, Ontario, Canada;
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Emilio D. Poggio
4Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio; and
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Cheryl A. Winkler
5Basic Research Laboratory, National Cancer Institute, Leidos Biomedical Research, Frederick Laboratory for Cancer Research, Frederick, Maryland and
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Jeffrey B. Kopp
6Kidney Disease Branch of National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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Abstract

Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1.73 m2; P=0.04). At a median of 12 years after donation, donors with the APOL1 high-risk genotype had lower eGFR (57±18 versus 67±15 ml/min per 1.73 m2; P=0.02) and faster decline in eGFR after adjusting for predonation eGFR (1.19; 95% confidence interval, 0 to 2.3 versus 0.4; 95% confidence interval, 0.1 to 0.7 ml/min per 1.73 m2 per year, P=0.02). Two donors developed ESRD; both carried the APOL1 high-risk genotype. In a subgroup of 115 donors matched to 115 nondonors by APOL1 genotype, we did not find a difference between groups in the rate of eGFR decline (P=0.39) or any statistical interaction by APOL1 status (P=0.92). In conclusion, APOL1 high-risk genotype in black living kidney donors associated with greater decline in postdonation kidney function. Trajectory of renal function was similar between donors and nondonors. The association between APOL1 high-risk genotype and poor renal outcomes in kidney donors requires validation in a larger study.

  • kidney donation
  • renal function
  • human genetics
  • Copyright © 2018 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 29 (4)
Journal of the American Society of Nephrology
Vol. 29, Issue 4
April 2018
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APOL1 Genotype and Renal Function of Black Living Donors
Mona D. Doshi, Mariella Ortigosa-Goggins, Amit X. Garg, Lihua Li, Emilio D. Poggio, Cheryl A. Winkler, Jeffrey B. Kopp
JASN Apr 2018, 29 (4) 1309-1316; DOI: 10.1681/ASN.2017060658

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APOL1 Genotype and Renal Function of Black Living Donors
Mona D. Doshi, Mariella Ortigosa-Goggins, Amit X. Garg, Lihua Li, Emilio D. Poggio, Cheryl A. Winkler, Jeffrey B. Kopp
JASN Apr 2018, 29 (4) 1309-1316; DOI: 10.1681/ASN.2017060658
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More in this TOC Section

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Cited By...

  • APOL1 Nephropathy: From Genetics to Clinical Applications
  • Clinical Applications of Genetic Discoveries in Kidney Transplantation: a Review
  • Apolipoprotein L1 Gene Testing Comes of Age
  • Genetic Testing for APOL1 Genetic Variants in Clinical Practice: Finally Starting to Arrive
  • Self-Reported Incident Hypertension and Long-Term Kidney Function in Living Kidney Donors Compared with Healthy Nondonors
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  • Evaluation of Potential Living Kidney Donors in the APOL1 Era
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