Do African Americans have a higher risk of kidney disease?

One-third of dialysis patients are African American. Learn more about the gene that puts African Americans at higher risk in this video with Griffin Rodgers, MD, the National Institutes of Health director of diabetes, digestive and kidney disease.

Transcript

00:00

African-Americans make up about 13% of the US population, but they represent 33% of patients on dialysis.

00:08

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00:17

At one point, for example, we thought that hypertension was the underlying cause of a lot of the end stage kidney disease

00:26

that we see in African-Americans. African-Americans make up about 13% of the US population,

00:33

but they represent 33% of patients on dialysis. So there's almost a three-fold increase in the number.

00:40

And a number of years ago our Institute funded a trial called the African-American Study

00:47

of Kidney Disease, because at that point, it was thought that there were certain antihypertensive drugs that didn't work in African-Americans.

00:55

But that was never tested in a rigorous manner. And in fact, when we did test it, it turns out that it worked just as well in that population,

01:03

perhaps even better than the standard therapies. We did find, though, that as one did control their blood

01:10

pressure to a more acceptable range, the kidney disease continued to progress, despite the fact that one was treating what was considered to be the underlying

01:19

cause. And that, as well as the larger studies, again,

01:25

on these genome-wide associations, uncovered the fact that this very common variation

01:32

in this gene called APOL1 accounts for almost all of that excess tendency towards African-Americans

01:41

to develop either chronic kidney disease or to go on to progressive kidney disease. And how this actually works is still not entirely known,

01:51

how having this abnormal protein is so toxic to the kidney cells.

01:58

If we had-- but I have to say, this is an area of very active investigation because this may launch a new class of drugs

02:06

to target the kidney disease, not only in them, but potentially even in other patients as well.