Kidney Diseases Are Increasing in Africa: The Role of Genetic Risk Factors

Source: French to English Tester Published on: 2026-04-21

Source: The Conversation – in French– By Segun Fatumo, Professor and Chair of Genomic Diversity, Queen Mary University of London

Every minute, yourkidneyswork intensively. They filter about 200 liters of blood, eliminate waste, balance salts and fluids, and regulate blood pressure. All this is done without any conscious effort on your part.

But when your kidneys begin to fail, the consequences are devastating. This notably leads to fatigue, fluid accumulation, and cardiac complications. Some people eventually need dialysis or a transplant to stay alive.

Kidney diseases are one of the causes of death whose prevalence is increasing the fastest worldwide. Approximately850 million peoplelive with one form or another of kidney disease, which is more than the combined number of people affected by diabetes and cancer. Chronic kidney disease – when your kidneys slowly lose their ability to perform their function –is responsibleabout 1.5 million deaths each year worldwide, and this number is increasing.

But kidney disease develops silently, with few symptoms. When these symptoms appear, the disease is already severe.

And this burden is not distributed equally. People of African descent arefour times more likelyto develop the most severe form of kidney failure that people of European descent. In sub-Saharan Africa, rates of hypertension and type 2 diabetes are also increasing. These two diseases are the leading causes of kidney damage. Approximately30% of adults in sub-Saharan Africasuffer from high blood pressure, and25 million (one adult in 20) are affected by diabetes)– most without diagnosis or treatment.

Sub-Saharan Africa has fewer nephrologists, dialysis facilities, and transplant services per capita than the rest of the world. Africa as a whole hasless than one nephrologist per million inhabitants. In some African countries, there is not a single nephrologist. Theglobal averageis about 10 per million. In high-income countries, this figure reaches 23 per million. For most Africans with kidney failure, there is simply no treatment available.

It is therefore essential to identify at-risk individuals before their kidneys stop functioning.

Ourstudyrecently published fills an important gap in this field. We are members of theKidneyGenAfrica consortium, a pan-African partnership aiming to achieve excellence in research and training in the field of genomics of kidney diseases.

We have discovered new genetic variants indicating a risk of kidney disease in African populations. We have also highlighted differences between the genetic risks faced by people living in Africa, on the one hand, and people of African origin living in North America and Europe, on the other hand.

This shows how important it is for medicine to rely on research adapted to the people concerned.

Understanding kidney disease

Kidney disease does not appear suddenly. It often develops gradually, under the effect of a combination of factors. Some people carry genetic variants, small differences in their DNA, which make their kidneys more vulnerable to damage.

Others face environmental risks such as a diet high in salt, uncontrolled hypertension, or infections related to diabetes. The use of medicinal plants, contaminated water, and environmental toxins also constitute risks.

In most cases, it is the combination of these factors that determines who gets sick and at what speed. But until recently, African populations were barely present in the scientific debate on this subject. Africa, which is home to human populationsthe most genetically diverseof the planet, was represented only in a tiny part of global genomic research. This is starting to change.

Large genetic study on Africans

We analyzed the genomic data of approximately 26,000 people from East, West, and Southern Africa, as well as around 81,000 people of African ancestry living elsewhere. This is the largest genetic study ever conducted on kidney function among Africans on the continent.

Our study provides new insight into the genetics of chronic kidney diseases within various African populations. It will also support future work aimed at improving the prevention, diagnosis, and treatment of kidney diseases within these populations and worldwide.

The team used a method called “genome-wide association study,” which analyzes the entire human genetic code in order to identify variants linked to a particular trait or disease. Here, the indicator studied was the estimated glomerular filtration rate, a standard blood test result that measures how effectively the kidneys filter waste. A lower score indicates poorer kidney function and a higher risk of disease.

By analyzing only populations from continental Africa, the study identified four relevant genetic locations, including two that had never been reported before.

Including populations of African ancestry from the diaspora, this number has increased to 19 sites, including three new ones. Four of these genetic sites have been located with great precision. This means that the team was able to identify the specific genetic variant most likely to be at the origin of the effect, rather than merely indicating a region of the genome where something relevant was occurring.

Each newly discovered site now constitutes a potential target for future drugs or diagnostic tools.

The study also examined polygenic scores, which are tools used to estimate an individual’s overall risk of developing a disease. A key conclusion was that scores established from data originating from genetically similar African populations yielded better results than those derived from larger but genetically distant data sets.

This is of considerable importance for medicine in Africa: science only works if the reference data corresponds to the population it is supposed to serve.

A gene that behaves differently on either side of the Atlantic

An important discovery of the study concerns a gene called APOL1.
Two variants of the APOL1 gene, known as G1 and G2, increase theriskof several severe forms of kidney diseases in African Americans. It was generally assumed that the same risk applied in the same way to people living on the African continent.

However, the data suggests otherwise. In continental Africa, these high-risk APOL1 variants are less frequent (and vary according to regions of Africa). Their association with reduced kidney function is significantly weaker than in the African diaspora.

This same gene seems to behave differently depending on a person’s place of residence and the population from which they originate.

This discovery is important for the development of drugs. Clinical trials on treatments for kidney diseases must include people living in Africa and not just people of African descent living elsewhere.

What must happen now

Several measures must result from this research for it to benefit public health:

African health systems must invest in early screening for kidney diseases. Simple and affordable blood and urine tests allow detection of kidney damage at a stage when lifestyle changes and drug treatment can be effective. Genetic risk assessment tools can help identify those who most need screening.
Pharmaceutical laboratories must include populations from the African continent in their clinical trials.
The global scientific community must continue to invest in African genomic infrastructures, including research cohorts and large groups of consenting participants whose genetic and health data are collected and stored for analysis purposes.

This study demonstrates that African scientists, in collaboration with African communities, can generate knowledge that changes the game on a global scale. It has helped to better refine the mastery of one of the most urgent health challenges.

Segun Fatumo benefits from funding from the Medical Research Council (MRC), Wellcome, and the NIH.

–ref. Kidney diseases are on the rise in Africa: the role of genetic risk factors –https://theconversation.com/kidney-diseases-are-increasing-in-africa-the-role-of-genetic-risk-factors-280600