APOL1 Genotype and Renal Function of Black Living Donors
APOL1 Genotype and Renal Function of Black Living Donors
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DOI：
10.1681/asn.2017060658
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发表时间：
2018-04-01
影响因子：
13.6
通讯作者：
Kopp, Jeffrey B.
中科院分区：
文献类型：
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作者：
Doshi, Mona D.;Ortigosa-Goggins, Mariella;Kopp, Jeffrey B.
黑人活体肾脏捐赠者患肾脏疾病的风险高于白色捐赠者。我们研究了APOL 1高风险基因型对黑人活体供肾者捐献后肾功能的影响，并评估了该基因型是否改变了捐献与供肾结果之间的相关性。我们将136名黑人活体供肾者分为APOL 1高风险（两个风险等位基因; n=19; 14%）或低风险（一个或零风险等位基因; n=117; 86%）基因型。两组献血前特征相似，除了APOL 1高危基因型献血者的基线eGFR（CKD-EPI方程）均值较低（98 +/- 17 vs 108 +/- 20 ml/min/1.73 m2; P=0.04）。在捐献后中位数12年，APOL 1高风险基因型捐献者的eGFR较低，（57 +/- 18 vs 67 +/- 15 ml/min/1.73 m2; P=0.02），校正献血前eGFR后eGFR下降更快（1.19; 95%置信区间，0至2.3 vs 0.4; 95%置信区间，0.1至0.7 ml/min/1.73 m2/年，P=0.02）。两个捐助者发展ESRD;都携带APOL 1高风险基因型。在一个由115名捐献者和115名非捐献者按APOL 1基因型匹配的亚组中，我们没有发现两组之间eGFR下降率的差异（P=0.39）或APOL 1状态的任何统计学相互作用（P=0.92）。总之，黑人活体供肾者中APOL 1高风险基因型与供肾后肾功能下降相关。供者和非供者的肾功能变化轨迹相似。APOL 1高风险基因型与肾脏供体肾脏预后不良之间的关联需要在更大规模的研究中进行验证。
Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean +/- SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98 +/- 17 versus 108 +/- 20 ml/min per 1.73 m(2); P=0.04). At a median of 12 years after donation, donors with the APOL1 high-risk genotype had lower eGFR (57 +/- 18 versus 67 +/- 15 ml/min per 1.73 m(2); P=0.02) and faster decline in eGFR after adjusting for predonation eGFR (1.19; 95% confidence interval, 0 to 2.3 versus 0.4; 95% confidence interval, 0.1 to 0.7 ml/min per 1.73 m(2) per year, P=0.02). Two donors developed ESRD; both carried the APOL1 high-risk genotype. In a subgroup of 115 donors matched to 115 nondonors by APOL1 genotype, we did not find a difference between groups in the rate of eGFR decline (P=0.39) or any statistical interaction by APOL1 status (P=0.92). In conclusion, APOL1 high-risk genotype in black living kidney donors associated with greater decline in postdonation kidney function. Trajectory of renal function was similar between donors and nondonors. The association between APOL1 high-risk genotype and poor renal outcomes in kidney donors requires validation in a larger study.