Among Black patients with COVID-19, those who have the apolipoprotein L1 (APOL1) high-risk genotype are at increased risk for acute kidney injury (AKI), new findings presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings suggest.

In a retrospective study of 135 Black patients who had a positive PCR test result for SARS-CoV-2, the novel coronavirus that causes COVID-19, those who had the APOL1 high-risk genotype (2 risk alleles) had significant 7.1-, 5.4-, and 4.4-fold increased odds of stage 2 or higher AKI, persistent AKI, and AKI requiring renal replacement therapy, respectively, compared with those who had 0 or 1 APOL1 risk alleles, Terrance Wickman, MD, of Ochsner Health System in New Orleans, Louisiana, and collaborators reported in a poster presentation. The high-risk genotype also was significantly associated with 5.6- and 25.2-fold increased odds of new overt proteinuria and new persistent overt proteinuria, respectively.

The incidence of APOL1 high-risk genotype was 14.8%, consistent with previous studies, according to the investigators. Patients had a median age of 60 years.

Continue Reading

Dr Wickman’s team defined AKI as an increase in serum creatinine of 0.3 mg/dL or more  from baseline known or presumed to have occurred within the previous 7 days. They defined persistent AKI as absence of recovery within 3 days.


Wickman TJ, Matute-Trochez L, Braga J, Arthur JM, Larsen CP, Velez JCQ. Risk of acute kidney injury in COVID-19 is increased in Blacks with apolipoprotein L1 (APOL1) high-risk genotype. Presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings, April 6-10. Poster 25.