A groundbreaking study has confirmed that genetic factors play a significant role in the high prevalence of kidney disease among West Africans.
Researchers found that the APOL1 gene variants—G1 and G2—which evolved as a defense against sleeping sickness, now come at a steep cost. While these variants once helped protect populations in the region from a deadly parasitic disease, they also increase the risk of chronic kidney disease later in life.
For decades, scientists have puzzled over why black populations, both in Africa and the diaspora, face such a disproportionate burden of kidney failure. In the United States, for example, although black people make up only 13 to 14 percent of the population, they account for nearly one third of patients requiring dialysis or a kidney transplant. Conditions like hypertension, diabetes, and HIV exacerbate the risk, causing more severe kidney damage in blacks than in white populations.
The study, a major effort under the Human Heredity and Health in Africa (H3Africa) initiative spearheaded by the Kidney Disease Research Network, involved over 8,000 participants from Ghana and Nigeria. Researchers discovered that 43 percent of participants carried one APOL1 variant, while nearly 30 percent had two. Those with double variants were significantly more likely to develop chronic kidney disease than individuals with one or no variants, echoing findings from research on African Americans.
This evidence not only confirms the genetic link behind the high incidence of kidney disease in West Africans but also opens the door for improvements in both screening and treatment. By identifying individuals at higher risk, healthcare providers can tailor preventive measures more effectively. Moreover, the development of new drugs like Inaxaplin, which inhibits APOL1 function and reduces proteinuria, signals promising avenues for targeted therapy in patients suffering from APOL1-mediated kidney damage.
Experts say the implications of this study are far-reaching. With kidney disease imposing a heavy financial and social burden, especially in resource-limited settings, the potential to screen for high-risk individuals and offer more personalized treatments could mark a turning point in public health. The findings serve as a reminder that genetic factors, though evolved for survival in a very different context, can have unintended consequences for modern health.
