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Deprecated: Implicit conversion from float 296.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Front+Pediatr 2016 ; 4 (ä): ä Nephropedia Template TP
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Renal and Cardiovascular Morbidities Associated with APOL1 Status among African-American and Non-African-American Children with Focal Segmental Glomerulosclerosis #MMPMID27900314
Woroniecki RP; Ng DK; Limou S; Winkler CA; Reidy KJ; Mitsnefes M; Sampson MG; Wong CS; Warady BA; Furth SL; Kopp JB; Kaskel FJ
Front Pediatr 2016[]; 4 (ä): ä PMID27900314show ga
Background and objectives: African-American (AA) children with focal segmental glomerulosclerosis (FSGS) have later onset disease that progresses more rapidly than in non-AA children. It is unclear how APOL1 genotypes contribute to kidney disease risk, progression, and cardiovascular morbidity in children. Design, setting, participants, and measurements: We examined the prevalence of APOL1 genotypes and associated cardiovascular phenotypes among children with FSGS in the Chronic Kidney Disease in Children (CKiD) study; an ongoing multicenter prospective cohort study of children aged 1?16?years with mild to moderate kidney disease. Results: A total of 140 AA children in the CKiD study were genotyped. High risk (HR) APOL1 genotypes were present in 24% of AA children (33/140) and were associated with FSGS, p?0.001. FSGS was the most common cause of glomerular disease in children with HR APOL1 (89%; 25/28). Of 32 AA children with FSGS, 25 (78%) had HR APOL1. Compared to children with low risk APOL1 and FSGS (comprising 36 non-AA and 7 AA), children with HR APOL1 developed FSGS at a later age, 12.0 (IQR: 9.5, 12.5) vs. 5.5 (2.5, 11.5) years, p?=?0.004, had a higher prevalence of uncontrolled hypertension (52 vs. 33%, p?=?0.13), left ventricular hypertrophy (LVH) (53 vs. 12%, p?0.01), C-reactive protein?>?3?mg/l (33 vs. 15%, p?=?0.12), and obesity (48 vs. 19%, p?=?0.01). There were no differences in glomerular filtration rate, hemoglobin, iPTH, or calcium?phosphate product. Conclusion: AA children with HR APOL1 genotype and FSGS have increase prevalence of obesity and LVH despite a later age of FSGS onset, while adjusting for socioeconomic status. Treatment of obesity may be an important component of chronic kidney disease and LVH management in this population.