APOL1 variants and kidney disease. There is no such thing as a free lunch.

A recent study by Genovese et al. unraveled the findings of the intensively discussed gene region around MYH9 and its association with non-diabetic chronic kidney disease in African-Americans. First, it is not the genetic variation in MYH9 but in the neighbouring APOL1 that causes the strong association with disease in African-Americans and second, the study showed strong evidence for a positive selection against vulnerability for Trypanosoma brucei rhodesiense infection but at the price of a higher susceptibility of non-diabetic chronic kidney disease. This overview reviews the findings and the possible impact of the study mentioned above as well as of related studies.