APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease

Derek M. Fine, Walter G. Wasser, Michelle M. Estrella, Mohamed G. Atta, Michael Kuperman, Revital Shemer, Arun Rajasekaran, Shay Tzur, Lorraine C. Racusen, Karl Skorecki

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

With earlier institution of antiretroviral therapy, kidney diseases other than HIV-associated nephropathy (HIVAN) predominate in HIV-infected persons. Outcomes for these diseases are typically worse among those infected with HIV, but the reasons for this are not clear. Here, we examined the role of APOL1 risk variants in predicting renal histopathology and progression to ESRD in 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy. We used survival analysis to determine time to ESRD associated with APOL1 genotype. Among the 29 patients with two APOL1 risk alleles, the majority (76%) had FSGS and 10% had hypertensive nephrosclerosis. In contrast, among the 54 patients with one APOL1 risk allele, 47%had immune-complex GNas the predominant lesion and only 23% had FSGS. Among the 25 patients with no APOL1 risk allele, 40%had immune-complex GN and 12%had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD. In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03). In summary, these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients.

Original languageEnglish
Pages (from-to)343-350
Number of pages8
JournalJournal of the American Society of Nephrology
Volume23
Issue number2
DOIs
Publication statusPublished - 01-02-2012
Externally publishedYes

Fingerprint

Kidney Diseases
Chronic Kidney Failure
HIV
Alleles
Antigen-Antibody Complex
AIDS-Associated Nephropathy
Nephrosclerosis
Kidney
Survival Analysis
African Americans
Genotype
Observation
Biopsy

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Fine, D. M., Wasser, W. G., Estrella, M. M., Atta, M. G., Kuperman, M., Shemer, R., ... Skorecki, K. (2012). APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. Journal of the American Society of Nephrology, 23(2), 343-350. https://doi.org/10.1681/ASN.2011060562
Fine, Derek M. ; Wasser, Walter G. ; Estrella, Michelle M. ; Atta, Mohamed G. ; Kuperman, Michael ; Shemer, Revital ; Rajasekaran, Arun ; Tzur, Shay ; Racusen, Lorraine C. ; Skorecki, Karl. / APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. In: Journal of the American Society of Nephrology. 2012 ; Vol. 23, No. 2. pp. 343-350.
@article{2d425165d3eb423fa7ad30b7f12955a2,
title = "APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease",
abstract = "With earlier institution of antiretroviral therapy, kidney diseases other than HIV-associated nephropathy (HIVAN) predominate in HIV-infected persons. Outcomes for these diseases are typically worse among those infected with HIV, but the reasons for this are not clear. Here, we examined the role of APOL1 risk variants in predicting renal histopathology and progression to ESRD in 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy. We used survival analysis to determine time to ESRD associated with APOL1 genotype. Among the 29 patients with two APOL1 risk alleles, the majority (76{\%}) had FSGS and 10{\%} had hypertensive nephrosclerosis. In contrast, among the 54 patients with one APOL1 risk allele, 47{\%}had immune-complex GNas the predominant lesion and only 23{\%} had FSGS. Among the 25 patients with no APOL1 risk allele, 40{\%}had immune-complex GN and 12{\%}had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD. In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03). In summary, these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients.",
author = "Fine, {Derek M.} and Wasser, {Walter G.} and Estrella, {Michelle M.} and Atta, {Mohamed G.} and Michael Kuperman and Revital Shemer and Arun Rajasekaran and Shay Tzur and Racusen, {Lorraine C.} and Karl Skorecki",
year = "2012",
month = "2",
day = "1",
doi = "10.1681/ASN.2011060562",
language = "English",
volume = "23",
pages = "343--350",
journal = "Journal of the American Society of Nephrology : JASN",
issn = "1046-6673",
publisher = "American Society of Nephrology",
number = "2",

}

Fine, DM, Wasser, WG, Estrella, MM, Atta, MG, Kuperman, M, Shemer, R, Rajasekaran, A, Tzur, S, Racusen, LC & Skorecki, K 2012, 'APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease', Journal of the American Society of Nephrology, vol. 23, no. 2, pp. 343-350. https://doi.org/10.1681/ASN.2011060562

APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease. / Fine, Derek M.; Wasser, Walter G.; Estrella, Michelle M.; Atta, Mohamed G.; Kuperman, Michael; Shemer, Revital; Rajasekaran, Arun; Tzur, Shay; Racusen, Lorraine C.; Skorecki, Karl.

In: Journal of the American Society of Nephrology, Vol. 23, No. 2, 01.02.2012, p. 343-350.

Research output: Contribution to journalArticle

TY - JOUR

T1 - APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease

AU - Fine, Derek M.

AU - Wasser, Walter G.

AU - Estrella, Michelle M.

AU - Atta, Mohamed G.

AU - Kuperman, Michael

AU - Shemer, Revital

AU - Rajasekaran, Arun

AU - Tzur, Shay

AU - Racusen, Lorraine C.

AU - Skorecki, Karl

PY - 2012/2/1

Y1 - 2012/2/1

N2 - With earlier institution of antiretroviral therapy, kidney diseases other than HIV-associated nephropathy (HIVAN) predominate in HIV-infected persons. Outcomes for these diseases are typically worse among those infected with HIV, but the reasons for this are not clear. Here, we examined the role of APOL1 risk variants in predicting renal histopathology and progression to ESRD in 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy. We used survival analysis to determine time to ESRD associated with APOL1 genotype. Among the 29 patients with two APOL1 risk alleles, the majority (76%) had FSGS and 10% had hypertensive nephrosclerosis. In contrast, among the 54 patients with one APOL1 risk allele, 47%had immune-complex GNas the predominant lesion and only 23% had FSGS. Among the 25 patients with no APOL1 risk allele, 40%had immune-complex GN and 12%had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD. In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03). In summary, these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients.

AB - With earlier institution of antiretroviral therapy, kidney diseases other than HIV-associated nephropathy (HIVAN) predominate in HIV-infected persons. Outcomes for these diseases are typically worse among those infected with HIV, but the reasons for this are not clear. Here, we examined the role of APOL1 risk variants in predicting renal histopathology and progression to ESRD in 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy. We used survival analysis to determine time to ESRD associated with APOL1 genotype. Among the 29 patients with two APOL1 risk alleles, the majority (76%) had FSGS and 10% had hypertensive nephrosclerosis. In contrast, among the 54 patients with one APOL1 risk allele, 47%had immune-complex GNas the predominant lesion and only 23% had FSGS. Among the 25 patients with no APOL1 risk allele, 40%had immune-complex GN and 12%had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD. In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03). In summary, these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients.

UR - http://www.scopus.com/inward/record.url?scp=84856840591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856840591&partnerID=8YFLogxK

U2 - 10.1681/ASN.2011060562

DO - 10.1681/ASN.2011060562

M3 - Article

C2 - 22135313

AN - SCOPUS:84856840591

VL - 23

SP - 343

EP - 350

JO - Journal of the American Society of Nephrology : JASN

JF - Journal of the American Society of Nephrology : JASN

SN - 1046-6673

IS - 2

ER -