Compared to white Americans, genetic factors in African Americans with chronic kidney disease (CKD) put them at a greater risk for end-stage renal disease (ESRD).
This is according to a new study released in the New England Journal of Medicine. Researchers at Johns Hopkins University and the University of Maryland contributed data from two separate studies: the African American Study of Kidney Disease and Hypertension (AASK) and the Chronic Renal Insufficiency Cohort Study (CRIC).
Both studies identified high risk genetic variants in the APOL1 gene that speed up kidney disease progression and substantially increase the risk of developing kidney failure, compared to whites and blacks with low risk variants, with or without diabetes. Approximately 1 in 10 blacks possess the high risk variants, though it is very uncommon in whites.
Senior author Lawrence J. Appel, MD, MPH, professor of medicine, epidemiology, and international health at the Johns Hopkins Medical Institutions, noted the importance of the APOL1 gene and its effect on kidney disease progression in blacks.
"Blacks with chronic kidney disease and the high-risk genetic variants were more likely to have kidney disease that progressed, compared to both blacks without the high-risk genotype and whites," he said.
Appel also stated that African Americans with low-risk variants still had a higher risk of developing kidney failure than whites.
"What we found is pretty remarkable that variations in a single gene account for much of the racial disparity in kidney disease progression and risk for end-stage kidney disease," says co-lead author Afshin Parsa, MD, MPH, assistant professor of medicine at the University of Maryland School of Medicine. "If it were possible to reduce the effect of this gene, there could be a very meaningful decrease in progressive kidney and end-stage kidney disease within blacks."