Today, 23andMe added a new Genetic Health Risk report on APOL1-related chronic kidney disease that has particular relevance for customers with African ancestry.
Chronic kidney disease is a condition in which the kidneys stop working properly over time. It’s estimated that at least 40 percent of adults in the U.S. will develop chronic kidney disease during their lifetime [1]. If left untreated, chronic kidney disease can lead to complications including heart disease or stroke, anemia, bone problems, a weakened immune system, and kidney failure. Because chronic kidney disease often has no symptoms at first, up to 90 percent of people with the condition aren’t aware they have it [2].
Two Variants in Report
The Chronic Kidney Disease (APOL1-Related) Genetic Health Risk report* includes two variants in the APOL1 gene that can increase the risk of developing chronic kidney disease. These two variants — called G1 and G2 — are most common in people of African descent: about 13 percent of African Americans have two APOL1 risk variants, which puts them at increased risk for chronic kidney disease and several types of end-stage kidney disease (also called kidney failure). In addition, kidneys from donors with two APOL1 risk variants tend to survive for a shorter time after transplantation [3].
“We hope that this report can help guide conversations with a healthcare professional so that customers can work with their doctor to help manage their risk for chronic kidney disease,” said 23andMe Product Scientist Ruth Tennen.
Chronic Kidney Disease in African Americans
In the U.S., African Americans are about three times as likely to develop end-stage kidney disease as Americans of European descent [2], and it’s thought that the APOL1 G1 and G2 variants account for a large proportion of this excess risk.
Although there is currently no evidence that particular interventions are more or less effective at reducing chronic kidney disease risk in people with two APOL1 risk variants, studies have reported support in the African American community for offering APOL1 testing. In these studies, participants have highlighted that such testing could increase awareness and knowledge about kidney disease, motivate a healthier lifestyle, provide insight into potential risks for family members, and provide opportunities for future research that could help eliminate racial disparities in end-stage kidney disease [4].
Other Factors Also Influence Risk
Despite the impact of the APOL1 G1 and G2 variants on chronic kidney disease risk, most cases of chronic kidney disease are not caused by these two variants. In addition to genetics, many other factors can influence the chances of developing chronic kidney disease, including age, family history, and lifestyle factors. Diabetes and high blood pressure are two of the biggest risk factors for chronic kidney disease in adults [5] [6].
The Chronic Kidney Disease (APOL1-Related) Genetic Health Risk report is available to 23andMe Health + Ancestry customers who are genotyped on the V5 version of our chip. Not yet a customer, find out more here.
[1] McMahon GM et al. (2017). “Residual lifetime risk of chronic kidney disease.” Nephrol Dial Transplant. 32(10):1705-1709. [https://pubmed.ncbi.nlm.nih.gov/27358274/]
[2] Centers for Disease Control and Prevention. “Chronic Kidney Disease in the United States, 2019.” [https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html]
[3] Freedman BI et al. (2018). “APOL1-Associated Nephropathy: A Key Contributor to Racial Disparities in CKD.” Am J Kidney Dis. 72(5 Suppl 1):S8-S16. [https://pubmed.ncbi.nlm.nih.gov/30343724/]
[4] Umeukeje EM et al. (2019). “You Are Just Now Telling Us About This? African American Perspectives of Testing for Genetic Susceptibility to Kidney Disease.” J Am Soc Nephrol. 30(4):526-530. https://pubmed.ncbi.nlm.nih.gov/30858224/]
[5] American Heart Association. “Kidney Disease and Diabetes.” [https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/kidney-disease–diabetes]
[6] American Heart Association. “How High Blood Pressure Can Lead to Kidney Damage or Failure.” [https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-kidney-damage-or-failure]
*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person’s overall risk of developing the disease. The test is not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. The Chronic Kidney Disease (APOL1-Related) genetic health risk report (i) is indicated for reporting of the S342G and N388_Y389del variants in the APOL1 gene, which define the G1 and G2 haplotypes, respectively and (ii) describes if a person has variants associated with an increased risk of developing chronic kidney disease. The variants included in this report are the most common and best studied in people of African descent.