The Role of Dietary Nutrients in Chronic Kidney Disease Progression and Apolipoprotein L1 Nephropathy

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PROJECT SUMMARY/ABSTRACT Chronic kidney disease (CKD) individuals Among malignant Apolipoprotein L1 (APOL1). Approximately 13% of African Americans and 25% of West Africans carry high risk renal genotypes, comprising of any combination of the two APOL1 risk variants, G1 and G2. This re-submission for a National Institute of Diabetes and Digestive Kidney Diseases Patient-Oriented Research Career Development Award (K23) seeks to support Dr. Titilayo Ilori, an Assistant Professor at the Boston University School of Medicine, who wants to build a career focused on mechanistic and interventional studies on the effect of dietary factors and lifestyle on CKD incidence and progression in both low- and adequately-resourced settings, especially in the context of genetic and genomic risk variants. Dr. Ilori's prior research has focused on health disparities in CKD and secondary data analysis of nutrition-related exposures and outcomes in kidney disease. Dr. Ilori intends to extend the scope of her research towards designing prospective studies to study the role of dietary sodium and potassium in CKD progression and APOL1 Nephropathy in Africans. Accordingly, her K23 training is focused on acquiring skills in global health research, nutritional and genetic epidemiology in CKD, statistical genetics and advanced biostatistics skills in longitudinal data analysis, and biomarkers of CKD. We propose a research project that leverages the Human Hereditary and Health in Africa Kidney Disease Research Network and addresses the following research aims: 1) a cross-sectional and prospective examination of the associations of dietary sodium, potassium, and oxalate intake – assessed through 24h urine collections in Africans; 2) a cross-sectional and prospective study to determine the associations of dietary patterns with CKD and CKD progression; 3) diet:gene interaction studies to examine whether dietary factors (sodium, potassium, oxalate, or dietary patterns) modify the effect of association of APOL1 renal genotypes on CKD progression. This is an important project because it may identify if dietary factors are modifiable risk factors for CKD progressions in Africans in SSA, where the cost of dialysis and renal transplantation is prohibitive. Additionally, evidence that diet alters the risk of nephropathy in those with high-risk APOL1 renal risk alleles could be important in investigating new therapeutic targets for APOL1 Nephropathy. is effectively a “death sentence” in Sub-Saharan Africa (SSA) where <2% of with end stage renal disease (ESRD) have access to maintenance dialysis or transplantation. Africans with CKD, there is a faster decline in kidney function and earlier onset of ESRD. This CKD phenotype is largely attributable to variants in the gene encoding