John Jeffrey Carr
Professor of Radiology, Biomedical Informatics and Cardiovascular Medicine
Last active: 1/10/2020

Apolipoprotein L1 and Chronic Kidney Disease Risk in Young Potential Living Kidney Donors.

Locke JE, Sawinski D, Reed RD, Shelton B, MacLennan PA, Kumar V, Mehta S, Mannon RB, Gaston R, Julian BA, Carr JJ, Terry JG, Kilgore M, Massie AB, Segev DL, Lewis CE
Ann Surg. 2018 267 (6): 1161-1168

PMID: 28187045 · PMCID: PMC5805656 · DOI:10.1097/SLA.0000000000002174

OBJECTIVE - The aim of this study was to develop a novel chronic kidney disease (CKD) risk prediction tool for young potential living kidney donors.

SUMMARY OF BACKGROUND DATA - 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).

METHODS - 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.

RESULTS - 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.

CONCLUSIONS - 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.

MeSH Terms (15)

Adolescent Adult African Americans Apolipoprotein L1 European Continental Ancestry Group Female Follow-Up Studies Genotype Humans Kidney Transplantation Living Donors Male Renal Insufficiency, Chronic Risk Assessment Young Adult

Connections (2)

This publication is referenced by other Labnodes entities: