Modifiable adiposity-related risk for chronic kidney disease in APOL1 variant carriers: Pilot study results

Background: Apolipoprotein L1 (APOL1) genetic variants are associated with the development of chronic kidney disease (CKD), but disease expression appears to depend on metabolic and environmental modifiers. Obesity is a risk factor for several chronic diseases. However, the relationship between obesity, body fat, and the development of kidney disease mediated by APOL1 risk variants is unknown. Aim: This study examined relationships among APOL1 risk variants, nutritional status, with a focus on anthropometry and body composition, and selected renal function biomarkers in individuals with CKD. Methods: Adults with CKD were genotyped for APOL1 variants, resulting in APOL1 risk and APOL1 non-risk groups. Results: The APOL1 risk group showed higher body mass index, increased central abdominal fat, and greater body fat compared with established reference values (p < 0.05). This group also showed high serum creatinine levels and a low estimated glomerular filtration rate, both abnormal ranges (p < 0.05). Conclusions: These findings demonstrate excessive body and abdominal fat as a relevant target for precision nutrition strategies to reduce CKD risk and support management in APOL1-associated kidney disease. Also, it is necessary to identify carriers before the onset of CKD and to use medical nutrition therapy to prevent or delay disease progression.