Original Investigation

Apolipoprotein L1 Gene Genotype and Kidney Outcomes After Living Kidney Donation

JAMA Internal Medicine 10.1001/jamainternmed.2026.0996

June 22, 2026 at 11:00 AM EDT

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Do living kidney donors with apolipoprotein L1 gene () high-risk genotypes have higher risk of reduced kidney function after kidney donation?In this cohort study of 445 Black kidney donors and 208 White kidney donors, nearly 2 decades after kidney donation, Black kidney donors with high-risk genotypes had more than twice the risk of reduced kidney function (estimated glomerular filtration rate <45 mL/min/1.73 m) than Black kidney donors without high-risk genotypes.Thsi study found that incorporating genotyping into the donor evaluation process will identify living kidney donation candidates at different risks for adverse outcomes after nephrectomy.

Corresponding Author: Chi-yuan Hsu, MD, MSc, Division of Nephrology, University of California, San Francisco, 500 Parnassus Ave, MUW 418A, Box 0532, San Francisco, CA 94143-0532 (chi-yuan.hsu@ucsf.edu).

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