Abstract
Background and objectives Trajectories of eGFR in patients with CKD are highly variable. Only a subset of patients with CKD experiences a steady decline in eGFR. The objective of our study was to investigate whether eGFR trajectory patterns differ by APOL1 risk status. Design, setting, participants, & measurements Our study was a longitudinal observational study of 622 participants in the African American Study of Kidney Disease and Hypertension with APOL1 genotyping and sufficient follow-up for estimating GFR trajectories. The predictor was APOL1 high-risk status (having two copies of theG1 orG2 risk alleles) versus low-risk status (zero or one copy of the risk alleles), and the outcomewas four eGFR trajectory patterns on the basis of the joint probabilities of linearity and progression: steady decline, unsteady decline, steady stable, and unsteady stable. Results Over amedian follow-up of 9 years, 24.0% of participants experienced steady eGFR decline, 25.9%had an unsteady decline, 25.6% were steady and stable, and 24.6% were unsteady but stable. Those experiencing steady decline had lower eGFR and higher urine protein-to-creatinine ratio at baseline than participants with the other eGFR trajectory patterns. The APOL1 high-risk group was associated with a greater odds for the steady decline pattern than the APOL1 low-risk group (unadjusted odds ratio, 2.45; 95% confidence interval, 1.62 to 3.69). This association remained significant after adjusting for demographic factors, baseline eGFR, urine proteinto-creatinine ratio, treatment assignment, and follow-up time (adjusted odds ratio, 1.59; 95% confidence interval, 1.00 to 2.52). Conclusions Among patients with CKD attributed to hypertension, those with the APOL1 high-risk genotype were more likely to experience a steady decline trajectory in eGFR than those without the APOL1 high-risk genotype. These findings suggest a persistent underlying pathophysiologic process in those patients with the APOL1 high-risk genotype.
Original language | English (US) |
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Pages (from-to) | 1353-1359 |
Number of pages | 7 |
Journal | Clinical Journal of the American Society of Nephrology |
Volume | 11 |
Issue number | 8 |
DOIs | |
State | Published - 2016 |
Keywords
- AASK (African American Study of Kidney Disease and Hypertension)
- African Americans
- Alleles
- Epidemiology and outcomes
- Follow-Up Studies
- Genotype
- Humans
- Kidney Diseases
- chronic kidney disease
- genetic renal disease
- glomerular filtration rate
- hypertension
ASJC Scopus subject areas
- Epidemiology
- Critical Care and Intensive Care Medicine
- Nephrology
- Transplantation