Genetic factors in common complex renal and cardiovascular diseases

A minority of subjects exposed to prolonged elevations in systemic blood pressure or serum glucose concentrations will develop progressive albuminuria or reduced glomerular filtration rates. Individuals from families that have multiple members with chronic kidney disease and individuals of color are more likely to develop renal microvascular involvement from these systemic diseases. In contrast, individuals of color are significantly less likely to develop macrovascular coronary and carotid artery disease, compared with European Americans. Coronary artery disease and atherosclerosis also aggregate in families. Familial aggregation and ethnic-specific risk strongly implicates genetic susceptibility in the common etiologies of kidney disease and atherosclerosis. While acknowledging the importance of environmental and sociocultural effects, this manuscript explores genomic regions and genes of interest involved in susceptibility to common, complex kidney diseases. In contrast to the genes that have been determined to cause monogenic kidney diseases, as are highlighted throughout this issue of Advances in Chronic Kidney Disease, the identification of genes that underlie complex diseases has proven to be more challenging, expensive, and time consuming. Nonetheless, developments have been made in this important area.