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MYH9  polymorphisms have been described to be associated with the risk of CKD in non-diabetic nephropathy, HIV nephropathy and FSGS. Predominating in black descendants,  MHY9  genetic variants could partially explain the excess risk of CKD associated with African ancestry. However, recent data suggests that  APOL1  gene co-segregate with  MYH9 , and could be the gene truly associated with CKD risk. In this study, we evaluated the role of  MYH9  and  APOL1  gene polymorphisms in the risk of CKD in Brazilian patients with lupus nephritis (LN). A retrospective analysis of 196 LN patients was done.  MYH9  rs4821480, rs2032487, rs4821481 and rs3752462,  APOL 1 rs73885319, rs16996616, rs60910145, rs71785313, and  APOL3  rs11089781 gene polymorphisms were determined. Genetic ancestry was ascertained both by autossomal ancestry and mitochondrial haplogroup. Primary outcome was defined as doubling of serum creatinine (DC) or end stage renal disease (ESRD). Sixty-two patients presented the PO. In our population,  MYH9  and  APOL1  were not in LD. None  APOL  polymorphism was associated with the PO, whereas rs3752462  MYH9  polymorphism showed a positive association (HR3.72, 95%CI 1.47–9.38, p = 0.005). When we analyzed the  MYH9  E1 haplotype, the GCCT carriers (1 or 2 alelles present in 29.7% in the PO group vs. 18.5% in controls) showed a significant association to the risk of PO, even after adjustments for baseline estimated creatinine clearance and autossomal ancestry (HR 2.0, 95%CI 1.2–3.4, p = 0.01). Our results show that in our population  MYH9 , but not  APOL1 , gene polymorphisms confer an increased risk of CKD in LN patients, independently of race.

MYH9 and APOL1 Gene Polymorphisms and the Risk of CKD in Patients with Lupus Nephritis from an Admixture Population