Kidney Week

Abstract: TH-PO847

APOL1 Genotyping, Knowledge, and Attitudes among African American Patients: Building a Cohort in a Midwestern US Urban Community

Session Information

• Race, Ethnicity, and Gender in Kidney Health and Care
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Lentine, Krista L., Saint Louis Univ, St. Louis, Missouri, United States

Krista L. Lentine, MD, PhD, FASN

• Philipneri, Marie D., Saint Louis Univ, St. Louis, Missouri, United States

Marie D. Philipneri, MD, PhD

• Memon, Aliza Anwar, Saint Louis Univ, St. Louis, Missouri, United States

Aliza Anwar Memon, MD

• Edwards, John C., Saint Louis Univ, St. Louis, Missouri, United States

John C. Edwards, MD, PhD

• Mosman, Amy, Saint Louis Univ, St. Louis, Missouri, United States

Amy Mosman, PA-C

• Miyata, Kana, Saint Louis Univ, St. Louis, Missouri, United States

Kana Miyata, MD

• Abu Al Rub, Fadee, Saint Louis Univ, St. Louis, Missouri, United States

Fadee Abu Al Rub, MD

• Carriker, Amber, Mid-America Transplant, St. Louis, Missouri, United States

Amber Carriker

• Freedman, Barry I., Wake Forest, Winston Salem, North Carolina, United States

Barry I. Freedman, MD

• Elsurer Afsar, Rengin, Saint Louis Univ, St. Louis, Missouri, United States

Rengin Elsurer Afsar, MD

• Afsar, Baris, Saint Louis Univ, St. Louis, Missouri, United States

Baris Afsar, MD

• Muiru, Anthony N., UCSF, San Francisco, California, United States

Anthony N. Muiru, MD, MPH

• Hsu, Chi-yuan, UCSF, San Francisco, California, United States

Chi-yuan Hsu, MD, MS, MSc, FASN

• Caliskan, Yasar, Saint Louis Univ, St. Louis, Missouri, United States

Yasar Caliskan, MD

Background

While some past studies assessed interest in apolipoprotein L1 (APOL1) genotyping among focus groups, few studies examine attitudes and knowledge combined with the opportunity to receive individual genotyping.

Methods

We offered APOL1 genetic testing and surveyed knowledge, attitudes and concerns related to APOL1 testing and kidney risk management among self-identified African American patients (NCT05656261) including 3 mo. follow-up (Fig 1A).

Results

Among 263 participants with genotyping results to date (Jan 2019–March 2024), 16% had high-risk genotypes (2 APOL1 RRVs) and 84% were low-risk (0/1 RRV). Median eGFR₂₀₂₁ was 47.7 in APOL1 low-risk vs. 42.2 ml/min/1.73 m² in high-risk groups. 50.7% of low-risk and 54.8% of high-risk groups reported family members with kidney problems. 24% of the 2 RRV group rated their overall health as poor to very poor, vs. 10% of the 0/1 RRV group.
At baseline, 86% reported they would want APOL1 testing for their family members. However, only 9.5% accepted formal genetic counseling beyond study-related education. Participants reported a variety of behavior changes may follow genotyping information (Fig 1B). The proportion who might worry about a high-risk genotype was lower at 3 mo. (18% vs 23%). 90% agreed to future research.

Conclusion

Self-identified African American patients at a Midwestern medical center report a high family history of kidney disease and were receptive to individual APOL1 genetic testing, not only in theory, but by participating in testing. Ongoing research is needed to define the interplay of genetic and environmental factors underlying kidney risk in this population.

Funding

• Private Foundation Support