APOL1 kidney disease affects millions of Americans, but for Black, African American, Afro-Caribbean, and Hispanic or Latino communities, the risk can be significantly higher, and a gene variant is part of the reason.
Scientists have discovered that the APOL1 gene variant can raise the risk of chronic kidney disease, such as FSGS and hypertension-associated kidney disease. Understanding this gene and what it means is a key step in protecting your health.
What Is APOL1?
APOL1 (apolipoprotein L1) is a gene that makes a protein your body uses to fight certain infections. Most people have a common version of this gene. However, two variants, called G1 and G2, are found much more often in people of Western or Central African descent.
Having one copy of the G1 or G2 variant is generally not a problem. But carrying two copies significantly increases the risk of developing kidney disease. People with two copies of the variant have about a 15-20% chance of developing kidney disease.
How Does APOL1 Affect the Kidneys?
The kidneys filter waste and extra fluid from your blood. When APOL1 variants are present in two copies, the protein they produce can damage the kidney filtering units over time. This damage can lead to:
- Focal segmental glomerulosclerosis (FSGS) — scarring of the kidney filters
- Hypertension-associated kidney disease — kidney damage linked to high blood pressure
- HIV-associated nephropathy — rapid kidney decline in people living with HIV
Who Is Most Affected?
Approximately 13% of Black Americans have two of the high-risk variants for the APOL1 gene. However, not everyone who carries two risk variants will develop kidney disease. For those who have both risk variants, there is a 1 in 5 chance of developing kidney disease.
What Can You Do?
If you are of Western or Central African descent, here are some steps you can take:
Talk to your doctor. Ask about your kidney health at your next checkup. Simple blood and urine tests can check how well your kidneys are working.
Know your family history. If relatives have had kidney disease, share that information with your healthcare provider.
Manage your risk factors. High blood pressure and diabetes are the leading causes of kidney disease for everyone. Keeping these under control is especially important if you carry APOL1 variants.
Consider genetic testing. Genetic testing is the only way to determine if you have the APOL1 gene. The decision to undergo genetic testing is made in consultation with a healthcare provider, as a physician or genetic counselor must order testing.
Stay informed. Research into APOL1 is moving quickly. Clinical trials are underway exploring treatments that may specifically help people with APOL1-related kidney disease. You can search for clinical trials with the National Library of Medicine search tool.
Key Takeaways
- APOL1 is a gene with variants that are more common in people of West and Central African ancestry.
- Carrying two high-risk variants raises risk but does not guarantee kidney disease.
- Regular checkups, blood pressure control, and open conversations with your doctor are your best tools.
- New treatments targeting APOL1 are in development.
Resources
APOL1-Mediated Kidney Disease (AMKD)- National Kidney Foundation
APOL1-Mediated Kidney Disease- American Kidney Fund
ClinicalTrials.gov- National Library of Medicine