ArticlePediatric nephrology (Berlin, Germany)2026
APOL1 and chronic kidney disease in pediatrics: a study from the Biorepository and Integrative Genomics Initiative.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAPOL1 variants confer increased risk for kidney disease in individuals of African ancestry, particularly in homozygous or compound heterozygous states. A missense variant, p.N264K, has been shown to attenuate this risk when co-inherited with the G2 allele. While these associations are established in adults, data in pediatric populations remain limited. Using the University of Tennessee Health Science Biorepository and Integrative Genomics initiative, we assessed chronic kidney disease (CKD) risk by APOL1 high-risk genotype and the potential protective effect of p.N264K in a diverse pediatric cohort.
methodsThis is a case-control study of African American children enrolled in the BIG initiative at Le Bonheur Children's Hospital (2014-2022). Composite CKD was defined by eGFR < 90 mL/min/1.73 m
resultsCKD cases had 8% higher odds of APOL1 HR status (Odds Ratio (OR): 1.08, 95% Confidence Interval (CI): 0.88-1.33). Stronger associations were observed in cases with albuminuria and APOL1 HR status (OR: 1.41, 95% CI: 1.02-1.92, p = 0.03). The p.N264K variant was detected in 4.3% of cases and 4.5% of controls, and appeared to attenuate CKD risk among HR individuals, though sample size limited statistical power.
conclusionsAPOL1 HR genotypes were associated with albuminuria in African American children. The p.N264K variant may modify this risk, warranting further study.
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