{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:29:46Z","timestamp":1786480186086,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Patients with nondiabetic apolipoprotein L1-mediated kidney disease progressed to dialysis and transplant faster than patients with other forms of nondiabetic CKD.<\/jats:p>\n <\/jats:list-item>\n \n Although patients with apolipoprotein L1-mediated kidney disease were younger with fewer comorbidities, kidney decline was accelerated underscoring the aggressive nature of apolipoprotein L1-mediated kidney disease.<\/jats:p>\n <\/jats:list-item>\n \n These findings highlight the need of targeted therapies for apolipoprotein L1-mediated kidney disease and earlier identification through genetic testing to improve patient outcomes.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Apolipoprotein L1-mediated kidney disease (AMKD) is an aggressive form of CKD. This study described characteristics of nondiabetic patients with AMKD and compared their disease progression with nondiabetic patients with other forms of CKD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study used clinical and biosample data from NashBio (NashBio contains electronic health records generated during clinical encounters at Vanderbilt University Medical Center). Nondiabetic patients with \u22651 CKD diagnosis code who were 10 years or older at index (date of first CKD diagnosis code in patient's medical record) were included. The AMKD and other forms of CKD cohorts were defined on the basis of the presence of apolipoprotein L1 risk alleles, and then their clinical and demographic characteristics were described. To assess progression patients were matched 1:1 on sex, presence of hypertension, and CKD stage at index and were followed until the last observation in the data. Progression outcomes including time from index to dialysis, kidney transplant, and diagnosis of CKD requiring KRT were assessed using Kaplan\u2013Meier analysis, with log-rank tests used to compare matched cohorts.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study included 645 patients with AMKD and 6749 patients with other forms of CKD. Patients with AMKD were significantly younger than patients with other CKD (median 44.0 versus 61.0 years;\n P<\/jats:italic>\n < 0.001) and had significantly less comorbidity burden such as cardiovascular diseases (16.9% versus 36.6%\n P<\/jats:italic>\n < 0.001). In addition, patients with AMKD had higher rates of CKD requiring KRT at index (59% versus 24%,\n P<\/jats:italic>\n < 0.001). After 1:1 matching, patients with AMKD reached dialysis and kidney transplant significantly faster than patients with other CKD (both\n P<\/jats:italic>\n < 0.001). Among patients who did not require KRT at index (\n n<\/jats:italic>\n =264 per cohort), patients with AMKD progressed to CKD requiring KRT significantly faster than patients with other CKD (\n P<\/jats:italic>\n < 0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Nondiabetic patients with AMKD experienced more rapid disease progression than patients with other forms of CKD, despite being younger and having lower comorbidity burden.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0000001097","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T17:00:49Z","timestamp":1768928449000},"page":"798-806","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics and Disease Progression among Nondiabetic Patients with Apolipoprotein L1-Mediated Kidney Disease and Patients with Other CKD"],"prefix":"10.34067","volume":"7","author":[{"given":"Ankit","family":"Shah","sequence":"first","affiliation":[{"name":"Vertex Pharmaceuticals Incorporated, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3010-2844","authenticated-orcid":false,"given":"Manish","family":"Maski","sequence":"additional","affiliation":[{"name":"Vertex Pharmaceuticals Incorporated, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8334-2211","authenticated-orcid":false,"given":"Debbie","family":"Goldschmidt","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5996-3147","authenticated-orcid":false,"given":"Ogo","family":"Egbuna","sequence":"additional","affiliation":[{"name":"Vertex Pharmaceuticals Incorporated, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0894-9184","authenticated-orcid":false,"given":"Ashley","family":"Holub","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyse","family":"Swallow","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Barber","sequence":"additional","affiliation":[{"name":"Vertex Pharmaceuticals Incorporated, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"4","key":"B2-20260430","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/ckj\/sfw047","article-title":"Chronic kidney disease in children","volume":"9","author":"Becherucci","year":"2016","journal-title":"Clin Kidney J."},{"issue":"1","key":"B3-20260430","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1038\/s41572-024-00589-9","article-title":"Chronic kidney disease","volume":"11","author":"Romagnani","year":"2025","journal-title":"Nat Rev Dis Primers."},{"issue":"19","key":"B5-20260430","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1001\/jama.2024.2667","article-title":"APOL1-mediated kidney disease","volume":"331","author":"Hopper","year":"2024","journal-title":"JAMA."},{"issue":"1","key":"B6-20260430","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1053\/j.ajkd.2023.12.014","article-title":"APOL1 nephropathy risk variants through the life course: a review","volume":"84","author":"Itoku","year":"2024","journal-title":"Am J Kidney Dis."},{"issue":"1","key":"B7-20260430","first-page":"64","article-title":"Safety and tolerability of the APOL1 inhibitor, inaxaplin, following single- and multiple-ascending doses in healthy adults","volume":"4","author":"Egbuna","year":"2024","journal-title":"Glomerular Dis."},{"issue":"2","key":"B8-20260430","doi-asserted-by":"crossref","first-page":"294","DOI":"10.2215\/CJN.15161219","article-title":"APOL1 nephropathy: from genetics to clinical applications","volume":"16","author":"Friedman","year":"2021","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B9-20260430","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000529227","article-title":"APOL1 and APOL1-Associated kidney disease: a common disease, an unusual disease gene - proceedings of the Henry Shavelle professorship","volume":"3","author":"Pollak","year":"2023","journal-title":"Glomerular Dis."},{"issue":"5","key":"B12-20260430","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1681\/ASN.0000000000000094","article-title":"Clinical and genetic characteristics of CKD patients with high-risk APOL1 genotypes","volume":"34","author":"Elliott","year":"2023","journal-title":"J Am Soc Nephrol."},{"issue":"12","key":"B13-20260430","doi-asserted-by":"crossref","first-page":"100563","DOI":"10.1016\/j.xkme.2022.100563","article-title":"APOL1 genotype, proteinuria, and the risk of kidney failure: a secondary analysis of the AASK (African American study of kidney disease and hypertension) and CRIC (chronic renal insufficiency cohort) studies","volume":"4","author":"Nguyen","year":"2022","journal-title":"Kidney Med."},{"issue":"4","key":"B14-20260430","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1093\/ndt\/gfr796","article-title":"APOL1 allelic variants are associated with lower age of dialysis initiation and thereby increased dialysis vintage in African and Hispanic Americans with non-diabetic end-stage kidney disease","volume":"27","author":"Tzur","year":"2012","journal-title":"Nephrol Dial Transplant."},{"issue":"suppl 2","key":"B15-20260430","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/ajt.16982","article-title":"OPTN\/SRTR 2020 annual data report: kidney","volume":"22","author":"Lentine","year":"2022","journal-title":"Am J Transplant."},{"issue":"5993","key":"B16-20260430","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1126\/science.1193032","article-title":"Association of trypanolytic ApoL1 variants with kidney disease in African Americans","volume":"329","author":"Genovese","year":"2010","journal-title":"Science."},{"issue":"3","key":"B17-20260430","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s00439-010-0861-0","article-title":"Missense mutations in the APOL1 gene are highly associated with end stage kidney disease risk previously attributed to the MYH9 gene","volume":"128","author":"Tzur","year":"2010","journal-title":"Hum Genet."},{"issue":"suppl 1","key":"B18-20260430","doi-asserted-by":"crossref","first-page":"i65","DOI":"10.1093\/ndt\/gfw402","article-title":"Therapeutics for APOL1 nephropathies: putting out the fire in the podocyte","volume":"32","author":"Heymann","year":"2017","journal-title":"Nephrol Dial Transplant."},{"issue":"6","key":"B19-20260430","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am J Epidemiol."}],"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001097","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:56:22Z","timestamp":1786478182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001097"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0000001097","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]},"assertion":[{"value":"2025-06-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}