Let's talk about APOL1-Related Chronic Kidney Disease

What is chronic kidney disease? 

Chronic kidney disease is a condition in which the kidneys stop working properly over time. Because the kidneys serve as filters for our blood, chronic kidney disease can cause excess fluid and waste from the blood to build up in the body. This can lead to health problems including bone damage, heart disease, and stroke. 

Is chronic kidney disease influenced by genetics?

Yes, risk for chronic kidney disease can be influenced by genetics. One gene that has been linked to an increased risk for chronic kidney disease is called APOL1. Two variants in the APOL1 gene can increase the risk of developing chronic kidney disease, and these variants are most common in people of African descent. About 13% of African Americans have a combination of APOL1 variants that puts them at increased risk for chronic kidney disease.

The APOL1 gene is shown located on chromosome 22.

What are some other risk factors for chronic kidney disease?

Although APOL1 variants can increase chronic kidney disease risk, most cases of chronic kidney disease are not caused by these two variants. In addition to genetics, many other factors can influence the risk for chronic kidney disease. High blood pressure and diabetes are two of the biggest risk factors. Risk for chronic kidney disease also increases with age, and rates of end-stage kidney disease (also called kidney failure) are more common in people of certain ethnicities, including African Americans, Native Americans, Native Hawaiians/Pacific Islanders, and people of Hispanic or Latino descent. Having a family history of chronic kidney disease and having certain other health conditions can also increase a person’s risk.

Signs and symptoms of chronic kidney disease

Chronic kidney disease often has no symptoms at first. Early chronic kidney disease is often diagnosed using blood and urine tests that look for loss of kidney function and the presence of protein in the urine. 

As the condition progresses, symptoms may include nausea, fatigue, high blood pressure, and swelling of the feet and ankles. Complications of chronic kidney disease include heart disease or stroke, anemia, bone problems, a weakened immune system, and kidney failure. 

Did you know?

Because chronic kidney disease often has no symptoms at first, up to 90% of people with the condition aren’t aware they have it.

Explore more

Curious to learn more? You can find out whether you’re at increased risk for APOL1-related chronic kidney disease through the 23andMe Chronic Kidney Disease (APOL1-Related) Genetic Health Risk report*. This report looks for two genetic variants in the APOL1 gene associated with an increased risk of developing chronic kidney disease; these two variants are most common in people of African descent. This report is available through the 23andMe Health + Ancestry Service.

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*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person’s overall risk of developing the disease. The test is not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. The Chronic Kidney Disease (APOL1-Related) genetic health risk report (i) is indicated for reporting of the S342G and N388_Y389del variants in the APOL1 gene, which define the G1 and G2 haplotypes, respectively and (ii) describes if a person has variants associated with an increased risk of developing chronic kidney disease. The variants included in this report are most common and best studied in people of African descent. For important information and limitations regarding genetic health risk reports, visit  https://www.23andme.com/test-info/.

References

American Heart Association. “How High Blood Pressure Can Lead to Kidney Damage or Failure.” Retrieved Apr 19, 2020, from https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-kidney-damage-or-failure.

American Heart Association. “Kidney Disease and Diabetes.” Retrieved Apr 19, 2020, from https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/kidney-disease–diabetes.

Centers for Disease Control and Prevention. “Chronic Kidney Disease in the United States, 2019.” Retrieved Apr 19, 2020, from https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html.

Freedman BI et al. (2018). “APOL1-Associated Nephropathy: A Key Contributor to Racial Disparities in CKD.” Am J Kidney Dis. 72(5 Suppl 1):S8-S16.

McMahon GM et al. (2017). “Residual lifetime risk of chronic kidney disease.” Nephrol Dial Transplant. 32(10):1705-1709.