The Biology: Inherited Disorders That Affect the Kidneys
Certain inherited disorders are more common in the Black community affect the kidneys. These include lupus, polycystic kidney disease, and mutations to the APOL1 gene. The good news is that discoveries in research are creating new opportunities for prevention, diagnosis, and treatment of many of these diseases.
Black people are 3 to 4 times more likely to develop lupus than White people. Lupus is a chronic disease that causes inflammation and pain. It commonly affects the skin, joints, and organs, such as the kidneys and heart. Lupus is typically inherited from one generation to the next. Researchers have linked about 100 genetic variations to lupus.
Black women are particularly affected by lupus and have lupus at 2 to 3 times the rate of White women. Recent research shows that 1 in 537 young black women have lupus. One study found that minority women get lupus at a younger age, have more serious complications, and a higher rate of death.
Polycystic Kidney Disease
Black Americans can inherit polycystic kidney disease (PKD). It is a genetic disorder—a person is born with one mutated copy of the PKD1 or PKD2 gene in each cell. About 90% of people who have PKD inherit the mutation from a parent.
PKD causes cysts in the kidneys and sometimes in the liver. Cysts in the kidneys interfere with their ability to filter wastes. Cysts can cause the kidneys to become enlarged and lead to kidney failure.
The high rate of kidney disease among Black Americans is a major health disparity. Some researchers think that this high rate is due to mutations in the apolipoprotein L1 (APOL1) gene. Everyone has the APOL1 gene. You inherit this gene from your parents. Sometimes this gene has variations or mutations. Black people who inherit 2 copies of APOL1 risk alleles are at a significantly increased risk for chronic kidney disease.
Talk to your healthcare provider about a special blood test for mutations in the APOL1 gene. People who carry these mutations should be aware of their increased risk. They should monitor their blood pressure and have kidney function checked regularly.