APOL1 Risk Variants and Acute Kidney Injury in Black Americans with COVID-19. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Larsen, Christopher P.; Wickman, Terrance J.; Braga, Juarez R.; Matute-Trochez, Luis A.; Hasty, Anna E.; Buckner, Lyndsey R.; Arthur, John M.; Haun, Randy S.; Velez, Juan Carlos Q.
• Is Part Of: Clinical journal of the American Society of Nephrology. Volume 16:Issue 12(2021)
• Page Start: 1790
• Page End: 1796
• Publication Date: 2021-12
• Subjects: acute renal failure -- genetic renal disease -- COVID-19 -- apolipoprotein L1 -- acute kidney injury
• DOI: 10.2215/CJN.01070121
• Languages: English
• ISSNs: 1555-9041

Abstract

Visual Abstract: Abstract : Background and objectives: Black Americans have a higher incidence of kidney disease compared with populations that do not have recent African ancestry. Two risk variants in the APOL1 are responsible for a portion of this higher risk. We sought to assess the odds of AKI conferred by APOL1 risk alleles in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design, setting, participants, & measurements: Black Americans who tested positive for coronavirus disease 2019 (COVID-19) were genotyped to determine APOL1 risk allele status. We assessed the incidence of AKI, persistent AKI, and AKI requiring KRT within 21 days of the PCR-based diagnosis. Outcomes were adjusted for age, sex, body mass index, hypertension, eGFR, and use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. Results: In total, 126 cases of SARS-CoV-2 infection were included within a 5-month period, with 16 (13%) and 110 (87%) cases with two and zero/one APOL1 high-risk alleles, respectively. AKI occurred in 11 (69%) patients with two APOL1 high-risk alleles and 39 (35%) patients with zero/one high-risk alleles (adjusted odds ratio, 4.41; 95% confidence interval, 1.11 to 17.52; P =0.04). Persistent AKI occurred in eight (50%) patients with two APOL1 high-risk alleles and 21 (19%) of those with zero/one high-risk alleles (adjusted odds ratio, 3.53; 95% confidence interval, 1.8 to 11.57; P =0.04). AKI KRT occurred in four (25%) of those with two APOL1 high-risk alleles and eight (7%) of those with zero/one high-risk alleles (adjusted odds ratio, 4.99; 95% confidence interval, 1.02 to 24.4, P =0.05). Conclusions: APOL1 high-risk alleles are associated with greater odds of AKI in Black American patients with COVID-19.