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APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease.
J Am Soc Nephrol 2012; 23(2):343-50JA

Abstract

With earlier institution of antiretroviral therapy, kidney diseases other than HIV-associated nephropathy (HIVAN) predominate in HIV-infected persons. Outcomes for these diseases are typically worse among those infected with HIV, but the reasons for this are not clear. Here, we examined the role of APOL1 risk variants in predicting renal histopathology and progression to ESRD in 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy. We used survival analysis to determine time to ESRD associated with APOL1 genotype. Among the 29 patients with two APOL1 risk alleles, the majority (76%) had FSGS and 10% had hypertensive nephrosclerosis. In contrast, among the 54 patients with one APOL1 risk allele, 47% had immune-complex GN as the predominant lesion and only 23% had FSGS. Among the 25 patients with no APOL1 risk allele, 40% had immune-complex GN and 12% had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD. In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03). In summary, these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients.

Authors+Show Affiliations

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. dfine1@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22135313

Citation

Fine, Derek M., et al. "APOL1 Risk Variants Predict Histopathology and Progression to ESRD in HIV-related Kidney Disease." Journal of the American Society of Nephrology : JASN, vol. 23, no. 2, 2012, pp. 343-50.
Fine DM, Wasser WG, Estrella MM, et al. APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. J Am Soc Nephrol. 2012;23(2):343-50.
Fine, D. M., Wasser, W. G., Estrella, M. M., Atta, M. G., Kuperman, M., Shemer, R., ... Skorecki, K. (2012). APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. Journal of the American Society of Nephrology : JASN, 23(2), pp. 343-50. doi:10.1681/ASN.2011060562.
Fine DM, et al. APOL1 Risk Variants Predict Histopathology and Progression to ESRD in HIV-related Kidney Disease. J Am Soc Nephrol. 2012;23(2):343-50. PubMed PMID: 22135313.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. AU - Fine,Derek M, AU - Wasser,Walter G, AU - Estrella,Michelle M, AU - Atta,Mohamed G, AU - Kuperman,Michael, AU - Shemer,Revital, AU - Rajasekaran,Arun, AU - Tzur,Shay, AU - Racusen,Lorraine C, AU - Skorecki,Karl, Y1 - 2011/12/01/ PY - 2011/12/3/entrez PY - 2011/12/3/pubmed PY - 2012/3/28/medline SP - 343 EP - 50 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 23 IS - 2 N2 - With earlier institution of antiretroviral therapy, kidney diseases other than HIV-associated nephropathy (HIVAN) predominate in HIV-infected persons. Outcomes for these diseases are typically worse among those infected with HIV, but the reasons for this are not clear. Here, we examined the role of APOL1 risk variants in predicting renal histopathology and progression to ESRD in 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy. We used survival analysis to determine time to ESRD associated with APOL1 genotype. Among the 29 patients with two APOL1 risk alleles, the majority (76%) had FSGS and 10% had hypertensive nephrosclerosis. In contrast, among the 54 patients with one APOL1 risk allele, 47% had immune-complex GN as the predominant lesion and only 23% had FSGS. Among the 25 patients with no APOL1 risk allele, 40% had immune-complex GN and 12% had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD. In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03). In summary, these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/22135313/APOL1_risk_variants_predict_histopathology_and_progression_to_ESRD_in_HIV_related_kidney_disease_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=22135313 DB - PRIME DP - Unbound Medicine ER -