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Hemostatic Factors, APOL1 Risk Variants, and the Risk of ESRD in the Atherosclerosis Risk in Communities Study.

TitleHemostatic Factors, APOL1 Risk Variants, and the Risk of ESRD in the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsTin A, Grams ME, Maruthur NM, Astor BC, Couper DJ, Mosley TH, Fornage M, Parekh RS, Coresh JJ
Secondary AuthorsKao W H L
JournalClin J Am Soc Nephrol
Volume10
Issue5
Pagination784-90
Date Published2015 May 07
ISSN1555-905X
KeywordsAfrican Americans, Alleles, Antithrombin III, Apolipoprotein L1, Apolipoproteins, Blood Coagulation Factors, European Continental Ancestry Group, Factor VIII, Female, Fibrinogen, Humans, Kidney Failure, Chronic, Lipoproteins, HDL, Male, Middle Aged, Protein C, Risk Assessment, Risk Factors, United States, von Willebrand Factor
Abstract

BACKGROUND AND OBJECTIVES: Hemostatic factors have been associated with kidney function decline, and evidence suggests stronger effects among African Americans. The presence of APOL1 renal risk variants, common in African Americans, might partly underlie this risk difference.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 13,337 participants in the Atherosclerosis Risk in Communities study were followed from 1987-1989 until 2010. Participants were categorized into three groups by ancestry and APOL1 risk status: European Americans (n=10,206), African Americans with zero or one APOL1 risk allele (n=2,733), and African Americans with two APOL1 risk alleles (n=398). ESRD events were ascertained through linkage to the US Renal Data System. Cox regression was used to estimate the risk for ESRD associated with hemostatic factors (factor VIIc, factor VIIIc, fibrinogen, von Willebrand factor, protein C, and antithrombin III).

RESULTS: There were 232 cases of ESRD over 21.5 years (European Americans, 119; African Americans with zero or one APOL1 risk allele, 94; African Americans with two APOL1 risk alleles, 19). In unadjusted and adjusted analysis of the overall population, higher levels of all hemostatic factors, except antithrombin III, were significantly associated with ESRD (all P

CONCLUSIONS: Higher levels of factor VIIc, VIIIc, fibrinogen, von Willebrand factor, and protein C were associated with ESRD risk, with a significantly stronger association of factor VIIIc and protein C in African Americans with two APOL1 risk alleles.

DOI10.2215/CJN.08340814
Alternate JournalClin J Am Soc Nephrol
PubMed ID25887069
PubMed Central IDPMC4422243
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
T32 DK007732 / DK / NIDDK NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
T32-HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States