Apolipoprotein L1 and kidney transplantation

Area of Science:

• Nephrology
• Genetics
• Immunology

Background:

• Apolipoprotein L1 (APOL1) gene variants are associated with nondiabetic kidney disease in individuals of African descent.
• Donor APOL1 genotype influences renal allograft survival, impacting kidney transplantation outcomes.

Purpose of the Study:

• To review recent advancements in APOL1 gene biology.
• To explore the implications of APOL1 variants for kidney donors and recipients.

Main Methods:

• Literature review of recent studies on APOL1 gene variants.
• Analysis of epidemiological data on APOL1 and kidney disease risk.
• Examination of experimental models for APOL1-related kidney injury.

Main Results:

• High-risk APOL1 variants in potential kidney donors correlate with an increased risk of chronic kidney disease (CKD) and lower estimated glomerular filtration rate (eGFR).
• APOL1 mutations may accelerate age-related podocyte loss, contributing to renal injury.
• Despite increased risk, the absolute risk of CKD in healthy individuals with high-risk APOL1 variants is considered low.

Conclusions:

• High-risk APOL1 mutations in kidney donors are associated with reduced graft survival and postdonation eGFR.
• APOL1 genotyping can serve as a valuable tool in assessing postdonation CKD risk.
• Informed decision-making for kidney donation and transplantation can be enhanced by incorporating APOL1 genetic information.