Show-Me State Times

Saint Louis University School of Medicine researchers are expanding their study on genetic testing to address racial disparities in kidney disease outcomes. The National Institutes of Health (NIH) has granted additional funding for the APOLLO study, which is among the largest national studies in transplantation.

The APOLLO study, coordinated by 13 lead centers across the U.S., including SSM Health Saint Louis University Hospital Transplant Center, aims to involve more transplant programs and patients nationwide. Over five years, it has enrolled 5,000 deceased donor kidneys, 2,700 recipients, over 250 living donors, and more than 230 recipients of living donations.

Research participation disparities persist within the African American community, particularly in organ donation contexts. Lentine urges African Americans to participate in research to improve kidney treatment outcomes. She is a prominent figure in nephrology at SLU and serves as medical director of living donation at SSM Health Saint Louis University Hospital.

APOLLO's findings will provide insights into how APOL1 gene variants affect organ acceptance from deceased donors and the health of living donors. "That information could change the way doctors consider race when they examine risk factors of an organ donor and transplant recipient," said Lentine.

APOL1 gene variants are present only in individuals of African ancestry and are linked to increased kidney failure risk. Approximately 15% of African Americans carry this high-risk genotype. "African ancestry is associated with an increased risk of kidney failure," Lentine stated.

Recent genetic breakthroughs show that genes, not race alone, contribute to kidney failure risks among African Americans. Categorizing race biologically rather than socially contributes to healthcare disparities in kidney treatment and transplants.

Researchers are exploring how APOL1 genotyping can aid chronic kidney disease patients in managing their risks. In collaboration with Mid-America Transplant Foundation, a pilot study offering APOL1 genotyping to African American patients is underway. More than 265 patients have been enrolled so far.

Scientists also aim to understand how APOL1 variants cause kidney damage and develop treatments to prevent it. A phase 2/3 clinical trial is being conducted at Saint Louis University as part of these efforts.