1
|
Ekulu PM, Nkoy AB, Betukumesu DK, Aloni MN, Makulo JRR, Sumaili EK, Mafuta EM, Elmonem MA, Arcolino FO, Kitetele FN, Lepira FB, van den Heuvel LP, Levtchenko EN. APOL1 Risk Genotypes Are Associated With Early Kidney Damage in Children in Sub-Saharan Africa. Kidney Int Rep 2019; 4:930-938. [PMID: 31317115 PMCID: PMC6612006 DOI: 10.1016/j.ekir.2019.04.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/23/2019] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction Apolipoprotein-L1 (APOL1) risk variants G1 and G2 increase the risk of chronic kidney disease (CKD), including HIV-related CKD, among African Americans. However, such data from populations living in Africa, especially children, remain limited. Our research aimed to determine the prevalence of APOL1 risk variants and to assess the association between these variants and early-stage CKD in the general pediatric population and HIV-infected children. Methods In a cross-sectional study, we enrolled 412 children from the general population and 401 HIV-infected children in Kinshasa, Democratic Republic of Congo (DRC). APOL1 high-risk genotype (HRG) was defined by the presence of 2 risk variants (G1/G1, G2/G2, or G1/G2), and low-risk genotype (LRG) by the presence of 0 or 1 risk variants. The main outcome was elevated albuminuria, defined as a urinary albumin/creatinine ratio ≥30 mg/g. Results APOL1 sequence analysis revealed that in the general population, 29 of 412 participants (7.0%) carried HRG, 84 of 412 (20.4%) carried the G1/G0 genotype, and 61 of 412 (14.8%) carried the G2/G0 genotype. In HIV-infected children, 23 of 401 (5.7%) carried HRG, and the same trend as in the general population was observed in regard to the prevalence of LRG. Univariate analysis showed that in the general population, 5 of 29 participants (17.2%) carrying HRG had elevated albuminuria, compared with 35 of 383 (9.0%) with LRG (odds ratio [OR] 2.1, 95% confidence interval [CI] 0.6-6.0; P = 0.13). In HIV-infected children, participants who carried APOL1 HRG had almost 22-fold increased odds of albuminuria compared to those with LRG. Conclusion The APOL1 risk variants are prevalent in children living in DRC. HRG carriers have increased odds of early kidney disease, and infection with HIV dramatically increases this probability.
Collapse
Affiliation(s)
- Pepe M Ekulu
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Agathe B Nkoy
- Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Dieumerci K Betukumesu
- Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Michel N Aloni
- Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean Robert R Makulo
- Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Ernest K Sumaili
- Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Eric M Mafuta
- Department of Biostatistics, Health Public School, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Mohamed A Elmonem
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Fanny O Arcolino
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Faustin N Kitetele
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Kalembelembe, Kinshasa, Democratic Republic of Congo
| | - François B Lepira
- Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Lambertus P van den Heuvel
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Pediatric Nephrology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Elena N Levtchenko
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Pediatric Nephrology, University Hospital Leuven, Leuven, Belgium
| |
Collapse
|