APOL1 Variant and Kidney Disease—Reply

In Reply We thank Dr Hilliard for her thoughtful comments regarding our Insights on APOL1-mediated kidney disease. Her hypothesis is that G1 and G2 variants of APOL1 are highly sodium-retentive and thus benefited the West African individuals who lived in the interior of the continent where salt was less abundant, leading to low sodium consumption (200 mg/d). According to this thesis, the descendants of these interior West African individuals who now live on the US diet of high sodium (3400-5000 mg/d), while retaining their sodium-retentive G1 and G2 APOL1, may be more vulnerable to developing kidney disease because of the high sodium.