Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun;267(6):1161-1168.
doi: 10.1097/SLA.0000000000002174.

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

Jayme E Locke  1 , Deirdre Sawinski  2 , Rhiannon D Reed  1 , Brittany Shelton  1 , Paul A MacLennan  1 , Vineeta Kumar  1 , Shikha Mehta  1 , Roslyn B Mannon  1 , Robert Gaston  1 , Bruce A Julian  1 , John J Carr  3 , James G Terry  3 , Meredith Kilgore  4 , Allan B Massie  5 , Dorry L Segev  5 , Cora E Lewis  6
Affiliations

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

Jayme E Locke et al. Ann Surg. 2018 Jun.

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Estimated 25-year risk for the development of chronic kidney disease among a cohort of 3,438 potential living kidney donor candidates from the CARDIA Study by baseline risk score.
See this image and copyright information in PMC

References

    1. 2012 Annual Report of the US Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1998–2012. Rockville, MD; Richmond, VA: Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation; Rockville, MD: United Network for Organ Sharing; Richmond, VA: University Renal Research and Education Association; Ann Arbor, MI:
    1. United States Renal Data System. Annual Data Report: Atlas of chronic kidney disease and end-stage renal disease. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2013.
    1. Segev DL, Muzaale AD, Caffo BS, et al. Perioperative mortality and long-term survival following live kidney donation. JAMA. 2010;303(10):959–966. - PubMed
    1. Muzaale AD, Massie AB, Wang MC, et al. Risk of end-stage renal disease following live kidney donation. JAMA. 2014;311(6):579–586. - PMC - PubMed
    1. Tarver-Carr ME, Powe NR, Eberhardt MS, et al. Excess risk of chronic kidney disease among African-American versus white subjects in the United States: a population-based study of potential explanatory factors. J Am Soc Nephrol. 2002;13(9):2363–2370. - PubMed

Publication types