the prevalence of APOL1 high risk alleles in dialysis population in the Netherlands

Patients with African ancestors have increased risk of having progressive kidney disease. One of the possible explanations is the APOL1 (apolipoprotein 1) gene. There have been two high risk alleles (G1 and G2) identified which are associated with increased risk of non-diabetic kidney disease in African Americans in the United states of America. Carriers from these risk alleles have a 4 to 20-fold chance on end stage renal disease (ESRD). The risk of carriers on ESRD after kidney donation remains up to now speculative. In the United states of America APOL1 variants are relatively common in African Americans, but absent in patient from European descent. The prevalence of the risk alleles among the Caucasian European population is reported to be less than 1 %. However, in certain urban areas of the Netherlands, such as Amsterdam, a relatively large proportion of the chronic dialysis population has a non-Western background. The prevalence of the polymorphisms of the APOL1 gene in this population is unknown.
Renal transplantation remains the optimal treatment for most patients with renal failure. It increases patient survival, patient quality of live and reduces costs. In the Netherlands, renal transplantation with a donor organ from a live donor is common. More than 50% of all transplantations are performed with live donor organ, resulting in excellent outcomes.
However, no excess harm should be done to the donor. Removal of the donor kidney and also late outcomes after transplantation should be as safe as possible. To this end candidate donors are meticulously screened and evaluated to make an accurate risk assessment. Up to now family members of non-Western background are approached by the donor team in a similar way as the Caucasian families when discussing the subject of organ transplantation and living donation.

APOL1 high risk alleles are present in patients with West African heritage.

it is a cross sectional study design: all patients characteristics for primary and secondary outcome will be collected at once, after the patients has given informed consent. This will be during hemodialysis or during check up for peritoneal dialysis. Also a doctor and the patients will be asked to fill in a questionnaire at the same visit. A blood sample will be collected during hemodialysis or during regular check up for peritoneal dialysis at the same time. With PCR the prevalence of none, one or two apol1 high risk gene will be determined.

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