APOL1 Kidney Risk Variants and Long-Term Kidney Function in Healthy Middle-Aged Black Individuals: The Atherosclerosis Risk in Communities (ARIC) Study

Rationale and ObjectiveImpact of Apolipoprotein L1(APOL1) genotype on future risk of kidney disease among middle-aged individuals with good kidney function is not well established.Study DesignLongitudinal cohort study.Setting p <0.001). At 25 years, white participants continued to have lower eGFRcr-cys than low-risk group (70±18 vs. 72±19 mL/min/1.73m2; p <0.001) but not compared to high risk APOL1 genotype (67±23 mL/min/1.7m2). There was no difference in uACR among groups at 10 and 25 years (p=0.87 and 0.91 respectively). The odds of developing CKD Stage 3a or worse were not different between low-risk and high-risk APOL1 group in both unadjusted and adjusted models (p=0.26 and p=0.39, respectively). At last follow-up, < 5% developed ESKD and 45% of individuals either died or reached ESKD with no difference in outcomes between the groups.LimitationsLow ascertainment due to death and long follow-upConclusionsAmong middle-aged individuals, APOL1 genotype does not appear to be a major driver of future risk of kidney disease.