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Jan 10, 2025Keywords:
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Contribution of Apolipoprotein L1 (APOL1) Risk Alleles to Kidney Disease in West Africa: an opportunity for treatment
Abstract
Chronic kidney disease (CKD) is common in sub-Saharan Africa (SSA) and develops in 10-14 per cent of adults. CKD leads, in many cases, to ill health, kidney failure, and premature death. The increased prevalence of CKD in Africa is in part due to inherited variants in the gene for Apolipoprotein L1 (APOL1). These variants developed some 10,000 years ago, and because they provided protection against fatal sleeping sickness (Trypanosoma brucei rhodesiense), the proportion of individuals with these variants rose to a high level in Africans in SSA. The APOL1 variants are associated with the development of CKD in Africans and people of African descent. The three fold increased risk of end stage kidney disease (ESKD) in African Americans compared to European Americans is now attributed largely to variants in the APOL1 gene in chromosome 22q12 locus, termed G1 and G2. The impact of the gene variants mirrors other evolutionary adaptations found in African populations. In this way, the gene is like the sickle cell gene, which protects people against malaria but can cause crises.
