Chronic kidney disease (CKD)
malignant Apolipoprotein L1 (APOL1).
Approximately 13% of African Americans and 25% of West Africans carry high risk renal genotypes,
comprising of any combination of the two APOL1 risk variants, G1 and G2.
This re-submission for a National Institute of Diabetes and Digestive Kidney Diseases Patient-Oriented
Research Career Development Award (K23) seeks to support Dr. Titilayo Ilori, an Assistant Professor at the
Boston University School of Medicine, who wants to build a career focused on mechanistic and interventional
studies on the effect of dietary factors and lifestyle on CKD incidence and progression in both low- and
adequately-resourced settings, especially in the context of genetic and genomic risk variants. Dr. Ilori's prior
research has focused on health disparities in CKD and secondary data analysis of nutrition-related exposures
and outcomes in kidney disease. Dr. Ilori intends to extend the scope of her research towards designing
prospective studies to study the role of dietary sodium and potassium in CKD progression and APOL1
Nephropathy in Africans. Accordingly, her K23 training is focused on acquiring skills in global health research,
nutritional and genetic epidemiology in CKD, statistical genetics and advanced biostatistics skills in longitudinal
data analysis, and biomarkers of CKD.
We propose a research project that leverages the Human Hereditary and Health in Africa Kidney Disease
Research Network and addresses the following research aims: 1) a cross-sectional and prospective
examination of the associations of dietary sodium, potassium, and oxalate intake – assessed through 24h urine
collections in Africans; 2) a cross-sectional and prospective study to determine the associations of dietary
patterns with CKD and CKD progression; 3) diet:gene interaction studies to examine whether dietary factors
(sodium, potassium, oxalate, or dietary patterns) modify the effect of association of APOL1 renal genotypes on
CKD progression. This is an important project because it may identify if dietary factors are modifiable risk
factors for CKD progressions in Africans in SSA, where the cost of dialysis and renal transplantation is
prohibitive. Additionally, evidence that diet alters the risk of nephropathy in those with high-risk APOL1 renal
risk alleles could be important in investigating new therapeutic targets for APOL1 Nephropathy.
is effectively a “death sentence” in Sub-Saharan Africa (SSA) where <2% of
with end stage renal disease (ESRD) have access to maintenance dialysis or transplantation.
Africans with CKD, there is a faster decline in kidney function and earlier onset of ESRD. This
CKD phenotype is largely attributable to variants in the gene encoding