Kidney disease in African Americans: genetic considerations.

African Americans shoulder a disproportionately high burden of kidney disease when compared with white Americans. While environmental factors such as poverty and poor health habits, and the high prevalence of risk factors such as obesity, contribute to the high rate of kidney disease in this population, genetic factors may also contribute. Studies of polymorphisms in genes encoding the proteins of the renin-angiotensin-aldosterone system have identified alleles that are associated with kidney disease or changes in renal function in some populations. A higher prevalence of such alleles in African Americans may contribute to the increased prevalence of kidney disease. Diabetes mellitus and hypertension, the main causes of end-stage renal disease in the United States, are more prevalent in African Americans. However, no direct links between diabetic or hypertensive kidney disease and any genetic polymorphisms seen in African Americans have been identified. Further research is thus required to elucidate the genetic components that contribute to the high prevalence of kidney disease in African Americans.