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We aimed to determine whether\n                      <jats:italic>APOL1<\/jats:italic>\n                      genotype status (high risk = 2 risk alleles; low risk = 0\u20131 risk alleles) and self\u2010reported race (Black; White) are associated with number of hospitalizations, incident chronic kidney disease (CKD), end\u2010stage renal disease (ESRD), and mortality among older adults participating in a community\u2010based cohort study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Observational longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>The Atherosclerosis Risk in Communities (ARIC) study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Community\u2010dwelling older adults (mean age = 75.8\u2009years; range = 66\u201390\u2009years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among 5,564 ARIC participants (78.2% White, 19.1%\n                      <jats:italic>APOL1<\/jats:italic>\n                      low\u2010risk Black, and 2.7%\n                      <jats:italic>APOL1<\/jats:italic>\n                      high\u2010risk Black), the proportion with creatinine and cystatin C\u2013based estimated glomerular filtration rate (eGFR\n                      <jats:sub>CrCys<\/jats:sub>\n                      ) below 60\u2009mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      at baseline was 40.6%, 34.8%, and 43.2%, respectively. Over a mean follow\u2010up of 5.1\u2009years,\n                      <jats:italic>APOL1<\/jats:italic>\n                      high\u2010risk Blacks had a 2.67\u2010fold higher risk for ESRD compared with low\u2010risk Blacks (95% confidence interval [CI] = 1.05\u20136.79) in models adjusted for age and sex. This association was no longer significant upon further adjustment for baseline eGFR\n                      <jats:sub>CrCys<\/jats:sub>\n                      and albuminuria (hazard ratio [HR] = 1.08; 95% CI = .39\u20132.96). Rate of hospitalizations and risks of mortality and incident CKD did not differ significantly by\n                      <jats:italic>APOL1<\/jats:italic>\n                      genotype status. Compared with Whites, Blacks had 1.85\u2010fold and 3.45\u2010fold higher risks for incident CKD and ESRD, respectively, in models adjusted for age, sex, eGFR\n                      <jats:sub>CrCys<\/jats:sub>\n                      , and albuminuria. These associations persisted after additional adjustments for clinical\/socioeconomic factors and\n                      <jats:italic>APOL1<\/jats:italic>\n                      genotype (incident CKD: HR = 1.38; 95% CI = 1.06\u20131.81; ESRD: HR = 3.20; 95% CI = 1.16\u20138.86).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Among older Black adults,\n                      <jats:italic>APOL1<\/jats:italic>\n                      high\u2010risk genotypes were associated with lower kidney function and therefore higher risk of ESRD. Racial disparities in incident kidney disease persisted in older age and were not fully explained by\n                      <jats:italic>APOL1<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16797","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T17:51:19Z","timestamp":1601315479000},"page":"155-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Race,\n                    <scp>\n                      <i>APOL1<\/i>\n                    <\/scp>\n                    Risk Variants, and Clinical Outcomes among Older Adults: The\n                    <scp>ARIC<\/scp>\n                    Study"],"prefix":"10.1111","volume":"69","author":[{"given":"Teresa K.","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Coresh","sequence":"additional","affiliation":[{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Medical Institutions  Baltimore Maryland USA"},{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Daya","sequence":"additional","affiliation":[{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Medical Institutions  Baltimore Maryland USA"},{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoshana H.","family":"Ballew","sequence":"additional","affiliation":[{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Medical Institutions  Baltimore Maryland USA"},{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Tin","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of Mississippi Medical Center  Jackson Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deidra C.","family":"Crews","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan 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