학술논문
End-Stage Renal Disease in African Americans With Lupus Nephritis Is Associated With APOL1
Document Type
Academic Journal
Author
Freedman, Barry I.; Langefeld, Carl D.; Andringa, Kelly K.; Croker, Jennifer A.; Williams, Adrienne H.; Garner, Neva E.; Birmingham, Daniel J.; Hebert, Lee A.; Hicks, Pamela J.; Segal, Mark S.; Edberg, Jeffrey C.; Brown, Elizabeth E.; Alarcón, Graciela S.; Costenbader, Karen H.; Comeau, Mary E.; Criswell, Lindsey A.; Harley, John B.; James, Judith A.; Kamen, Diane L.; Lim, Sam S.; Merrill, Joan T.; Sivils, Kathy L.; Niewold, Timothy B.; Patel, Neha M.; Petri, Michelle; Ramsey-Goldman, Rosalind; Reveille, John D.; Salmon, Jane E.; Tsao, Betty P.; Gibson, Keisha L.; Byers, Joyce R.; Vinnikova, Anna K.; Lea, Janice P.; Julian, Bruce A.; Kimberly, Robert P.
Source
Arthritis & Rheumatology. Feb 01, 2014 66(2):390-396
Subject
Language
English
ISSN
2326-5191
Abstract
OBJECTIVE.: METHODS.: RESULTS.: Ninety percent of the SLE patients were female. The mean ± SD age at SLE diagnosis was significantly lower in LN-ESRD cases than in SLE non-nephropathy controls (27.3 ± 10.9 years versus 39.5 ± 12.2 years). The mean ± SD time from SLE diagnosis to development of LN-ESRD in cases was 7.3 ± 7.2 years. The G1/G2 risk alleles were strongly associated with SLE-ESRD, with 25% of cases and 12% of controls having 2 nephropathy alleles (odds ratio [OR] 2.57, recessive model P = 1.49 × 10), and after adjustment for age, sex, and ancestry admixture (OR 2.72, P = 6.23 × 10). The age-, sex-, and admixture-adjusted population attributable risk for ESRD among patients with G1/G2 polymorphisms was 0.26, compared to 0.003 among European American patients. The mean time from SLE diagnosis to ESRD development was ~2 years earlier among individuals with APOL1 risk genotypes (P = 0.01). CONCLUSION.: APOL1 G1/G2 alleles strongly impact the risk of LN-ESRD in African Americans, as well as the time to progression to ESRD. The high frequency of these alleles in African Americans with near absence in European Americans explains an important proportion of the increased risk of LN-ESRD in African Americans.