The G1 and G2 APOL1 risk alleles are important risk factors for chronic kidney disease (CKD) among Black Americans; however, the genetic risk of CKD associated with APOL1 variants among individuals living in West Africa — the ancestral origin of most Black Americans — has not been thoroughly investigated. New findings from the H3Africa Kidney Disease Research Network and presented at ASN Kidney Week 2024 show that APOL1 risk variants are also important risk factors for the development and progression of CKD among individuals living in Ghana and Nigeria.

This case–control study included 8,355 participants, 5,578 of whom had CKD. Forty-three per cent of all participants carried one APOL1 risk allele and 29.7% carried two. Individuals with two APOL1 risk alleles had a 25% higher chance of CKD than individuals with one risk allele or no risk alleles (adjusted OR 1.25; 95% CI 1.11–1.40) and an 84% higher chance of focal segmental glomerulosclerosis (FSGS; adjusted OR, 1.84; 95% CI 1.30–2.61). However, these risks were also increased among individuals with one APOL1 risk allele (18% higher chance of CKD; adjusted OR 1.18; 95% CI 1.04–1.33 and a 61% higher chance of FSGS; adjusted OR 1.61; 95% CI 1.04–2.48). Among individuals with APOL1 risk alleles, the adjusted odds ratio for CKD also increased according to CKD stage, suggesting that APOL1 risk variants are also a risk factor for disease progression.