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Published in: BMC Nephrology 1/2015

Open Access 01-12-2015 | Research article

Apolipoprotein L1, income and early kidney damage

Authors: Ruth Tamrat, Carmen A Peralta, Salman M Tajuddin, Michele K Evans, Alan B Zonderman, Deidra C Crews

Published in: BMC Nephrology | Issue 1/2015

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Abstract

Background

The degree to which genetic or environmental factors are associated with early kidney damage among African Americans (AAs) is unknown.

Methods

Among 462 AAs in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, we examined the cross-sectional association between apolipoprotein L1 (APOL1) risk variants and income with: 1) mildly reduced eGFR (<75 mL/min/1.73 m2, creatinine-cystatin C equation) and 2) elevated urine albumin-to-creatinine ratio (ACR) (≥17 in men and ≥25 mg/g in women). High risk APOL1 status was defined by 2 copies of high-risk variants; low risk if 0 or 1 copy. Income groups were dichotomized as < $14,000/year (lowest income group) or ≥ $14,000/year. Logistic regression models were adjusted for age, sex, and % European ancestry.

Results

Overall, participants’ mean age was 47 years and 16% (n = 73) had high risk APOL1 status. Mean eGFR was 99 mL/min/1.73 m2. Mildly reduced eGFR was prevalent among 11% (n = 51). The lowest income group had higher adjusted odds (aOR) of mildly reduced eGFR than the higher income group (aOR 1.8, 95% CI 1.2-2.7). High-risk APOL1 was not significantly associated with reduced eGFR (aOR 1.5, 95% CI 0.9-2.5). Among 301 participants with ACR data, 7% (n = 21) had elevated ACR. Compared to low-risk, persons with high-risk APOL1 had higher odds of elevated ACR (aOR 3.8, 95% CI 2.0-7.3). Income was not significantly associated with elevated ACR (aOR 1.8, 95% CI 0.7-4.5). There were no significant interactions between APOL1 and income.

Conclusions

Both genetic and socioeconomic factors may be important determinants of early kidney damage among AAs.
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Literature
1.
2.
go back to reference Vanhollebeke B, Pays E. The function of apolipoproteins L. Cell Mol Life Sci. 2006;63(17):1937–44.CrossRefPubMed Vanhollebeke B, Pays E. The function of apolipoproteins L. Cell Mol Life Sci. 2006;63(17):1937–44.CrossRefPubMed
3.
go back to reference Genovese G, Friedman DJ, Ross MD, Lecordier L, Uzureau P, Freedman BI, et al. Association of trypanolytic ApoL1 variants with kidney disease in African Americans. Science (New York, NY). 2010;329(5993):841–5.CrossRef Genovese G, Friedman DJ, Ross MD, Lecordier L, Uzureau P, Freedman BI, et al. Association of trypanolytic ApoL1 variants with kidney disease in African Americans. Science (New York, NY). 2010;329(5993):841–5.CrossRef
4.
go back to reference Freedman BI, Divers J, Palmer ND. Population ancestry and genetic risk for diabetes and kidney, cardiovascular, and bone disease: modifiable environmental factors may produce the cures. Am J Kidney Dis. 2013;62(6):1165–75.CrossRefPubMed Freedman BI, Divers J, Palmer ND. Population ancestry and genetic risk for diabetes and kidney, cardiovascular, and bone disease: modifiable environmental factors may produce the cures. Am J Kidney Dis. 2013;62(6):1165–75.CrossRefPubMed
5.
go back to reference Lipkowitz MS, Freedman BI, Langefeld CD, Comeau ME, Bowden DW, Kao WH, et al. Apolipoprotein L1 gene variants associate with hypertension-attributed nephropathy and the rate of kidney function decline in African Americans. Kidney Int. 2013;83(1):114–20.CrossRefPubMed Lipkowitz MS, Freedman BI, Langefeld CD, Comeau ME, Bowden DW, Kao WH, et al. Apolipoprotein L1 gene variants associate with hypertension-attributed nephropathy and the rate of kidney function decline in African Americans. Kidney Int. 2013;83(1):114–20.CrossRefPubMed
6.
go back to reference Kopp JB, Nelson GW, Sampath K, Johnson RC, Genovese G, An P, et al. APOL1 genetic variants in focal segmental glomerulosclerosis and HIV-associated nephropathy. J Am Soc Nephrol. 2011;22(11):2129–37.CrossRefPubMedPubMedCentral Kopp JB, Nelson GW, Sampath K, Johnson RC, Genovese G, An P, et al. APOL1 genetic variants in focal segmental glomerulosclerosis and HIV-associated nephropathy. J Am Soc Nephrol. 2011;22(11):2129–37.CrossRefPubMedPubMedCentral
7.
go back to reference Parsa A, Kao WH, Xie D, Astor BC, Li M, Hsu CY, et al. APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med. 2013;369(23):2183–96.CrossRefPubMedPubMedCentral Parsa A, Kao WH, Xie D, Astor BC, Li M, Hsu CY, et al. APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med. 2013;369(23):2183–96.CrossRefPubMedPubMedCentral
8.
go back to reference Friedman DJ, Kozlitina J, Genovese G, Jog P, Pollak MR. Population-based risk assessment of APOL1 on renal disease. J Am Soc Nephrol. 2011;22(11):2098–105.CrossRefPubMedPubMedCentral Friedman DJ, Kozlitina J, Genovese G, Jog P, Pollak MR. Population-based risk assessment of APOL1 on renal disease. J Am Soc Nephrol. 2011;22(11):2098–105.CrossRefPubMedPubMedCentral
9.
go back to reference Freedman BI, Langefeld CD, Turner J, Nunez M, High KP, Spainhour M, et al. Association of APOL1 variants with mild kidney disease in the first-degree relatives of African American patients with non-diabetic end-stage renal disease. Kidney Int. 2012;82(7):805–11.CrossRefPubMedPubMedCentral Freedman BI, Langefeld CD, Turner J, Nunez M, High KP, Spainhour M, et al. Association of APOL1 variants with mild kidney disease in the first-degree relatives of African American patients with non-diabetic end-stage renal disease. Kidney Int. 2012;82(7):805–11.CrossRefPubMedPubMedCentral
10.
go back to reference Foster MC, Coresh J, Fornage M, Astor BC, Grams M, Franceschini N, et al. APOL1 variants associate with increased risk of CKD among African Americans. J Am Soc Nephrol. 2013;24(9):1484–91.CrossRefPubMedPubMedCentral Foster MC, Coresh J, Fornage M, Astor BC, Grams M, Franceschini N, et al. APOL1 variants associate with increased risk of CKD among African Americans. J Am Soc Nephrol. 2013;24(9):1484–91.CrossRefPubMedPubMedCentral
11.
go back to reference Crews DC, Pfaff T, Powe NR. Socioeconomic factors and racial disparities in kidney disease outcomes. Semin Nephrol. 2013;33(5):468–75.CrossRefPubMed Crews DC, Pfaff T, Powe NR. Socioeconomic factors and racial disparities in kidney disease outcomes. Semin Nephrol. 2013;33(5):468–75.CrossRefPubMed
12.
go back to reference Bruce MA, Beech BM, Crook ED, Sims M, Wyatt SB, Flessner MF, et al. Association of socioeconomic status and CKD among African Americans: the Jackson Heart Study. Am J Kidney Dis. 2010;55(6):1001–8.CrossRefPubMedPubMedCentral Bruce MA, Beech BM, Crook ED, Sims M, Wyatt SB, Flessner MF, et al. Association of socioeconomic status and CKD among African Americans: the Jackson Heart Study. Am J Kidney Dis. 2010;55(6):1001–8.CrossRefPubMedPubMedCentral
13.
go back to reference Crews DC, Charles RF, Evans MK, Zonderman AB, Powe NR. Poverty, race, and CKD in a racially and socioeconomically diverse urban population. Am J Kidney Dis. 2010;55(6):992–1000.CrossRefPubMedPubMedCentral Crews DC, Charles RF, Evans MK, Zonderman AB, Powe NR. Poverty, race, and CKD in a racially and socioeconomically diverse urban population. Am J Kidney Dis. 2010;55(6):992–1000.CrossRefPubMedPubMedCentral
14.
go back to reference Crews DC, McClellan WM, Shoham DA, Gao L, Warnock DG, Judd S, et al. Low income and albuminuria among REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants. Am J Kidney Dis. 2012;60(5):779–86.CrossRefPubMedPubMedCentral Crews DC, McClellan WM, Shoham DA, Gao L, Warnock DG, Judd S, et al. Low income and albuminuria among REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants. Am J Kidney Dis. 2012;60(5):779–86.CrossRefPubMedPubMedCentral
15.
go back to reference Volkova N, McClellan W, Klein M, Flanders D, Kleinbaum D, Soucie JM, et al. Neighborhood poverty and racial differences in ESRD incidence. J Am Soc Nephrol. 2008;19(2):356–64.CrossRefPubMedPubMedCentral Volkova N, McClellan W, Klein M, Flanders D, Kleinbaum D, Soucie JM, et al. Neighborhood poverty and racial differences in ESRD incidence. J Am Soc Nephrol. 2008;19(2):356–64.CrossRefPubMedPubMedCentral
16.
go back to reference Norris K, Nissenson AR. Race, gender, and socioeconomic disparities in CKD in the United States. J Am Soc Nephrol. 2008;19(7):1261–70.CrossRefPubMed Norris K, Nissenson AR. Race, gender, and socioeconomic disparities in CKD in the United States. J Am Soc Nephrol. 2008;19(7):1261–70.CrossRefPubMed
17.
go back to reference Franco M, Diez-Roux AV, Nettleton JA, Lazo M, Brancati F, Caballero B, et al. Availability of healthy foods and dietary patterns: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2009;89(3):897–904.CrossRefPubMedPubMedCentral Franco M, Diez-Roux AV, Nettleton JA, Lazo M, Brancati F, Caballero B, et al. Availability of healthy foods and dietary patterns: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2009;89(3):897–904.CrossRefPubMedPubMedCentral
18.
go back to reference Johnson AE, Boulware LE, Anderson CA, Chit-Ua-Aree T, Kahan K, Boyer LL, et al. Perceived barriers and facilitators of using dietary modification for CKD prevention among African Americans of low socioeconomic status: a qualitative study. BMC Nephrol. 2014;15(1):194.CrossRefPubMedPubMedCentral Johnson AE, Boulware LE, Anderson CA, Chit-Ua-Aree T, Kahan K, Boyer LL, et al. Perceived barriers and facilitators of using dietary modification for CKD prevention among African Americans of low socioeconomic status: a qualitative study. BMC Nephrol. 2014;15(1):194.CrossRefPubMedPubMedCentral
19.
go back to reference Crews DC, Kuczmarski MF, Miller ER, 3rd, Zonderman AB, Evans MK, Powe NR: Dietary Habits, Poverty, and Chronic Kidney Disease in an Urban Population. Journal of renal nutrition: the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014 Crews DC, Kuczmarski MF, Miller ER, 3rd, Zonderman AB, Evans MK, Powe NR: Dietary Habits, Poverty, and Chronic Kidney Disease in an Urban Population. Journal of renal nutrition: the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014
20.
go back to reference Banerjee T, Crews DC, Wesson DE, Tilea A, Saran R, Rios Burrows N, et al. Dietary acid load and chronic kidney disease among adults in the United States. BMC Nephrol. 2014;15:137.CrossRefPubMedPubMedCentral Banerjee T, Crews DC, Wesson DE, Tilea A, Saran R, Rios Burrows N, et al. Dietary acid load and chronic kidney disease among adults in the United States. BMC Nephrol. 2014;15:137.CrossRefPubMedPubMedCentral
21.
go back to reference Lin J, Fung TT, Hu FB, Curhan GC. Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses’ Health Study. Am J Kidney Dis. 2011;57(2):245–54.CrossRefPubMedPubMedCentral Lin J, Fung TT, Hu FB, Curhan GC. Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses’ Health Study. Am J Kidney Dis. 2011;57(2):245–54.CrossRefPubMedPubMedCentral
22.
go back to reference Evans MK, Lepkowski JM, Powe NR, LaVeist T, Kuczmarski MF, Zonderman AB. Healthy aging in neighborhoods of diversity across the life span (HANDLS): overcoming barriers to implementing a longitudinal, epidemiologic, urban study of health, race, and socioeconomic status. Ethn Dis. 2010;20(3):267–75.PubMedPubMedCentral Evans MK, Lepkowski JM, Powe NR, LaVeist T, Kuczmarski MF, Zonderman AB. Healthy aging in neighborhoods of diversity across the life span (HANDLS): overcoming barriers to implementing a longitudinal, epidemiologic, urban study of health, race, and socioeconomic status. Ethn Dis. 2010;20(3):267–75.PubMedPubMedCentral
24.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–52.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–52.CrossRefPubMed
25.
go back to reference Shlipak MG, Matsushita K, Arnlov J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med. 2013;369(10):932–43.CrossRefPubMedPubMedCentral Shlipak MG, Matsushita K, Arnlov J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med. 2013;369(10):932–43.CrossRefPubMedPubMedCentral
26.
go back to reference Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med. 2012;367(1):20–9.CrossRefPubMedPubMedCentral Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med. 2012;367(1):20–9.CrossRefPubMedPubMedCentral
27.
go back to reference Pritchard JK, Stephens M, Donnelly P. Inference of population structure using multilocus genotype data. Genetics. 2000;155(2):945–59.PubMedPubMedCentral Pritchard JK, Stephens M, Donnelly P. Inference of population structure using multilocus genotype data. Genetics. 2000;155(2):945–59.PubMedPubMedCentral
28.
go back to reference Purcell S, Neale B, Todd-Brown K, Thomas L, Ferreira MA, Bender D, et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. Am J Hum Genet. 2007;81(3):559–75.CrossRefPubMedPubMedCentral Purcell S, Neale B, Todd-Brown K, Thomas L, Ferreira MA, Bender D, et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. Am J Hum Genet. 2007;81(3):559–75.CrossRefPubMedPubMedCentral
29.
go back to reference Warram JH, Gearin G, Laffel L, Krolewski AS. Effect of duration of type I diabetes on the prevalence of stages of diabetic nephropathy defined by urinary albumin/creatinine ratio. J Am Soc Nephrol. 1996;7(6):930–7.PubMed Warram JH, Gearin G, Laffel L, Krolewski AS. Effect of duration of type I diabetes on the prevalence of stages of diabetic nephropathy defined by urinary albumin/creatinine ratio. J Am Soc Nephrol. 1996;7(6):930–7.PubMed
30.
go back to reference Bruce MA, Beech BM, Sims M, Brown TN, Wyatt SB, Taylor HA, et al. Social environmental stressors, psychological factors, and kidney disease. J Investig Med. 2009;57(4):583–9.CrossRefPubMedPubMedCentral Bruce MA, Beech BM, Sims M, Brown TN, Wyatt SB, Taylor HA, et al. Social environmental stressors, psychological factors, and kidney disease. J Investig Med. 2009;57(4):583–9.CrossRefPubMedPubMedCentral
31.
go back to reference Sims M, Diez-Roux AV, Dudley A, Gebreab S, Wyatt SB, Bruce MA, et al. Perceived discrimination and hypertension among African Americans in the Jackson Heart Study. Am J Public Health. 2012;102 Suppl 2:S258–65.CrossRefPubMedPubMedCentral Sims M, Diez-Roux AV, Dudley A, Gebreab S, Wyatt SB, Bruce MA, et al. Perceived discrimination and hypertension among African Americans in the Jackson Heart Study. Am J Public Health. 2012;102 Suppl 2:S258–65.CrossRefPubMedPubMedCentral
32.
go back to reference Peralta CA, Risch N, Lin F, Shlipak MG, Reiner A, Ziv E, et al. The Association of African Ancestry and elevated creatinine in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Nephrol. 2010;31(3):202–8.CrossRefPubMed Peralta CA, Risch N, Lin F, Shlipak MG, Reiner A, Ziv E, et al. The Association of African Ancestry and elevated creatinine in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Nephrol. 2010;31(3):202–8.CrossRefPubMed
Metadata
Title
Apolipoprotein L1, income and early kidney damage
Authors
Ruth Tamrat
Carmen A Peralta
Salman M Tajuddin
Michele K Evans
Alan B Zonderman
Deidra C Crews
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2015
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-015-0008-6

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