Kidney disease and APOL1

Abstract

Globally, chronic kidney disease (CKD) represents an important non-communicable disease with significant morbidity and mortality. An estimated 10% of the world's population had CKD in 2015 with approximately 1.2 million deaths in 2017 (1,2), and the burden is expected to rise at the rate of 6% per annum (3,4). By 2030, more than 70% of patients suffering from end-stage kidney disease (ESKD) worldwide will be in low and lower middle income countries of the world including African countries (5). Significant disparities in the burden of CKD exist worldwide, where economically disadvantaged communities, notably those on the African continent and those of the African diaspora, continue to bear a disproportionate burden of the disease (2,6). This disparity is fueled by a convergence of genetic and environmental risk factors (7,8). A recent meta-analysis showed an overall prevalence of CKD of 15.8% in the general population in Africa, with up to 4.6% of adults having moderate to severe kidney dysfunction (9). In Africa, more than 80% of the continental burden of CKD is in sub-Saharan Africa (SSA), with the highest prevalence in West Africa (8). The burden of CKD among African Americans, who share substantial genetic ancestry with West Africans (10), is similarly high; African Americans represent 13% of the USA population, but account for 35% of the patients on dialysis (11).