Table 1.

Preliminary recommendations for clinical testing of APOL1 kidney risk genotype

ConditionRecommendation for APOL1 Genetic Testing
FSGSConsider testing in selected patients for prognosis and possibly improved adherence
HIV-associated nephropathyConsider testing in selected patients for prognosis and possibly improved adherence
Other CKD with subnephrotic proteinuriaConsider testing in selected patients for prognosis and possibly improved adherence
Lupus nephritisConsider testing in selected patients for prognosis and possibly improved adherence
PreeclampsiaConsider testing pregnant women to identify those at increased risk for preeclampsia and who should receive close monitoring
Living kidney transplantTesting indicated for prognosis of donors and recipients
Deceased kidney donorsTesting indicated for prognosis of recipients
Kidney transplant recipientsNo testing of recipients, because recipient APOL1 genotype has no effect on kidney outcomes
  • For many of the kidney diseases shown, other factors may also contribute, such premature birth, obesity, uncontrolled hypertension, and failure to control an underlying disorder, such as HIV or lupus. Preliminary recommendations are suggested; professional society guidelines have not been published. The clinician and the patient must decide together whether the prognostic information for the particular condition would be useful to the patient, possibly increasing adherence to a particular screening or therapeutic regimen.