Apolipoprotein L1 genetic testing, family history of hypertension, and kidney disease in a Midwestern U.S. cohort.
Source: PubMed, NCBI / U.S. National Library of Medicine
Understanding how family history and genetic factors-particularly apolipoprotein L1 () renal risk variants (RRVs)-contribute to kidney disease risk among Black individuals continues to evolve. In a cohort of prospectively enrolled Black adults who underwentgenotyping and completed surveys at a Midwestern U.S. academic hospital (01/24/2019-03/21/2025; NCT05656261), we examinedRRV distribution in relation to family history, baseline clinical factors, and 3-month renal function change. Among 220 eligible participants, 17% (37/220) carriedhigh-risk genotypes (two RRVs). Family history of hypertension alone was reported by 37% (81/220), kidney disease alone by 3% (6/220), and both by 49% (109/220). High-risk genotypes were more common among those with both hypertension and kidney disease in their family (18%) versus those without either (12%). High-riskgenotype prevalence rose with increasing antihypertensive medication use (24% among those prescribed ≥4 agents) and was higher among individuals with lower race-free estimated glomerular filtration rate (eGFR) or albuminuria. Among 173 participants with eGFR values at 3-months, high-risk genotypes were more frequent among those with eGFR decline versus improvement (23% vs. 12%). high-risk genotypes were more common among individuals with a family history of hypertension and/or kidney disease, greater medication burden, lower kidney function, and early eGFR decline. The partial overlap between genetic and familial risk undersc
Abstract
Understanding how family history and genetic factors-particularly apolipoprotein L1 () renal risk variants (RRVs)-contribute to kidney disease risk among Black individuals continues to evolve. In a cohort of prospectively enrolled Black adults who underwentgenotyping and completed surveys at a Midwestern U.S. academic hospital (01/24/2019-03/21/2025; NCT05656261), we examinedRRV distribution in relation to family history, baseline clinical factors, and 3-month renal function change. Among 220 eligible participants, 17% (37/220) carriedhigh-risk genotypes (two RRVs). Family history of hypertension alone was reported by 37% (81/220), kidney disease alone by 3% (6/220), and both by 49% (109/220). High-risk genotypes were more common among those with both hypertension and kidney disease in their family (18%) versus those without either (12%). High-riskgenotype prevalence rose with increasing antihypertensive medication use (24% among those prescribed ≥4 agents) and was higher among individuals with lower race-free estimated glomerular filtration rate (eGFR) or albuminuria. Among 173 participants with eGFR values at 3-months, high-risk genotypes were more frequent among those with eGFR decline versus improvement (23% vs. 12%). high-risk genotypes were more common among individuals with a family history of hypertension and/or kidney disease, greater medication burden, lower kidney function, and early eGFR decline. The partial overlap between genetic and familial risk underscores the complex interplay of inherited, clinical, and environmental factors. Continued study and integrative strategies are needed to refine kidney disease risk stratification, enhance early identification, and guide prevention and treatment in at-risk populations.