Frontiers in Pediatrics (Nov 2016)

Renal and cardiovascular morbidities associated with APOL1 among African American and Non-African American children with focal segmental glomerulosclerosis.

  • Robert P Woroniecki,
  • Derek Ng,
  • Sophie Limou,
  • Cheryl A Winkler,
  • Kimberly Jean Reidy,
  • Mark Mitsnefes,
  • Matthew G Sampson,
  • Craig S Wong,
  • Bradley A Warady,
  • Susan L Furth,
  • Jeffrey B Kopp,
  • Frederick Jeffrey Kaskel

DOI
https://doi.org/10.3389/fped.2016.00122
Journal volume & issue
Vol. 4

Abstract

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Background and objectives: African American (AA) children with focal segmental glomerulosclerosis (FSGS) have later onset disease that progresses more rapidly than in non-AA children. It is unclear how APOL1 genotypes contribute to kidney disease risk, progression and cardiovascular morbidity in children. Design, setting, participants, & measurements: We examined the prevalence of APOL1 genotypes and associated cardiovascular phenotypes among children with FSGS in the Chronic Kidney Disease in Children (CKiD) study; an ongoing multicenter prospective cohort study of children aged 1-16 years with mild to moderate kidney disease.Results: A total of 140 AA children in the CKiD study were genotyped. HR APOL1 genotypes were present in 24% of AA children (33/140) and were associated with FSGS, p 3 mg/L (33% vs. 15%, p=0.12) and obesity (48% vs. 19%, p=0.01). There were no differences in glomerular filtration rate, hemoglobin, iPTH, or calcium-phosphate product. Conclusions: AA children with HR APOL1 genotype and FSGS have increase prevalence of obesity and LVH despite a later age of FSGS onset, while adjusting for socioeconomic status. Treatment of obesity may be an important component of CKD and LVH management in this population.

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