APOL1 Nephropathy-The Cause of Kidney Failure in Black Patients

In 1966, Martin Luther King, Jr. wrote, “Of all forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death. I see no alternative to direct action and creative nonviolence to raise the conscience of the nation.”

-There are 500,000 dialysis patients in the United States and 40 % are Black.

-Black individuals are 3-4 times more likely than Whites to develop kidney failure and need dialysis or transplantation

-In the Detroit Metropolitan Area, 75% of the dialysis patients are Black and 80% could have been spared this fate.

In 2010 the reason for this disparity was discovered and found to be genetic.

Black patients have a gene, APOL1, not found in Caucasians, and if a person receives one gene from both parents, there is a 20% chance that the person will develop kidney failure.

It is estimated that 50 % of Black people carry one dose of the gene and 14% have two doses of the gene and are at a 20 % risk for kidney failure. (20 %)

Recent studies have shown promising medications that can prevent the expression of the gene and may prevent the development of kidney failure and the need for dialysis.

The drug is inaxaplin, and studies in phase two have shown great promise; however, development has not been accelerated.

It took seven years to develop a drug to successfully treat HIV. A life-saving vaccine to prevent Covid-19 was developed in 9 months. What has caused the delay in the development of a cure for this affliction called APOL1 Nephropathy, a disease confined to the Black population?

Congress, NIH, and the CDC must be pressured to complete the narrative and raise the nation’s conscience.

Most physicians do not know of this. Most Black people do not know of this.

I need help to get the word out to the minority population, the medical establishments, and our politicians.

Olaf Kroneman M.D.