Key result
Black participants had lower urinary uromodulin levels than White participants, with a significant interaction of ethnicity on the relationship between CKD-risk SNPs and uUMOD/creatinine.
Why the study?
The genetic and nongenetic factors associated with urinary uromodulin in African populations remain unknown.
Cross-Sectional (n=3,145)
Yes
There are significant ethnic differences in the clinical and genetic determinants of urinary uromodulin levels, highlighting the need to consider ethnicity in GWAS and precision medicine for CKD.
Ethnic differences in uUMOD determinants should not yet guide practice; hypothesis-generating for ethnicity-stratified GWAS and precision medicine in CKD.
Introduction Single-nucleotide polymorphisms (SNPs) in the UMOD -PDILT genetic locus are associated with chronic kidney disease (CKD) in European populations, through their effect on urinary uromodulin (uUMOD) levels. The genetic and nongenetic factors associated with uUMOD in African populations remain unknown. Methods Clinical parameters, 3 selected UMOD-PDILT SNPs and uUMOD levels were obtained in 1202 young Black and White adults from the African-PREDICT study and 1943 middle aged Black adults from the PURE-NWP-SA study, 2 cross-sectional, observational studies. Results Absolute uUMOD and uUMOD/creatinine levels were lower in Black participants compared to White participants. The prime CKD-risk allele at rs12917707 was more prevalent in Black individuals, with strikingly more risk allele homozygotes compared to White individuals. Haplotype analysis of the UMOD-PDILT locus predicted more recombination events and linkage disequilibrium (LD) fragmentation in Black individuals. Multivariate testing and sensitivity analysis showed that higher uUMOD/creatinine associated specifically with risk alleles at rs12917707 and rs12446492 in White participants and with higher serum renin and lower urine albumin-to-creatinine ratio in Black participants, with a significant interaction of ethnicity on the relationship between all 3 SNPs and uUMOD/creatinine. The multiple regression model explained a greater percentage of the variance of uUMOD/creatinine in White adults compared to Black adults (23% vs. 8%). Conclusion We evidenced ethnic differences in clinical and genetic determinants of uUMOD levels, in particular an interaction of ethnicity on the relationship between CKD-risk SNPs and uUMOD. These differences should be considered when analyzing the role of uromodulin in kidney function, interpreting genome-wide association studies (GWAS), and precision medicine recommendations.
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Strauss‐Kruger et al. (2024) conducted a cross-sectional in Chronic kidney disease (n=3,145). UMOD-PDILT SNPs and Black ethnicity vs. White ethnicity was evaluated on Urinary uromodulin (uUMOD) and uUMOD/creatinine levels. Black participants had lower urinary uromodulin levels than White participants, with a significant interaction of ethnicity on the relationship between CKD-risk SNPs and uUMOD/creatinine.
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