lysis included African-American participants in the Atherosclerosis Risk in Communities (ARIC) study (N=3071), the Chronic Renal Insufficiency Cohort (CRIC; N=998), and the African American Study of Kidney Disease and Hypertension (AASK; N=609). Surrogate endpoints included three-year 30% and 40% decline in glomerular filtration rate (GFR), doubling of urine protein-to-creatinine ratio (UPCR), and >3 ml/min/1.73 m2 per year decline in GFR. Clinical outcomes included kidney failure requiring kidney replacement therapy, heart failure, cardiovascular disease, and death after three years.Results: 22% in AASK, 18% in CRIC, and 13% in ARIC had the APOL1 high risk genotype. Participants with the APOL1 high-risk genotype had higher risk of all three-year GFR outcomes but not doubling of UPCR, as well as kidney failure after three years. The three-year outcomes were strongly associated with kidney failure, with weaker but statistically significant associations with the development of heart failure, cardiovascular disease, and mortality. There were no differences in associations between short-term and long-term clinical outcomes by APOL1 risk status. Conclusions: Individuals with the APOL1 high risk genotype were more susceptible to three-year GFR-related endpoints and long-term kidney failure than individuals with the APOL1 low-risk genotype. There was no consistent difference in short-term-clinical outcome associations by APOL1 genotype, supporting the use of surrogates in APOL1-associated kidney disease. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

---

APOL1 相关肾病的替代终点：三个队列的评估


裂解包括社区动脉粥样硬化风险 （ARIC） 研究 （N=3071） 的非裔美国参与者、慢性肾功能不全队列 （CRIC;N=998）和非裔美国人肾脏疾病和高血压研究 （AASK;N=609）。替代终点包括肾小球滤过率 （GFR） 三年下降 30% 和 40%，尿蛋白与肌酐比值 （UPCR） 翻倍，以及 GFR 每年下降 >3 ml/min/1.73 m2。临床结局包括需要肾脏替代治疗的肾衰竭、心力衰竭、心血管疾病和三年后死亡。结果：AASK 中 22% 、 CRIC 中 18% 和 ARIC 中 13% 具有 APOL1 高危基因型。具有 APOL1 高危基因型的参与者发生所有 3 年 GFR 结局的风险较高，但 UPCR 没有翻倍，以及 3 年后肾衰竭的风险。三年结局与肾衰竭密切相关，与心力衰竭、心血管疾病和死亡率的发生相关性较弱，但具有统计学意义。APOL1 风险状态的短期和长期临床结局之间的关联没有差异。结论： 与具有 APOL1 低风险基因型的个体相比，具有 APOL1 高危基因型的个体更容易出现 3 年 GFR 相关终点和长期肾功能衰竭。APOL1 基因型的短期临床结果关联没有一致的差异，支持在 APOL1 相关肾病中使用替代物。美国肾脏病学会版权所有 © 2024...