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Conflict-of-interest: No conflict of interest is present. Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Peer-review started: June 12, 2014 First decision: August 14, 2014 Article in press: February 12, 2015""Core tip: There are striking ethnic differences in the prevalence of chronic kidney disease, including human immunodeficiency virus PIK-3 (HIV)-associated nephropathy (HIVAN), in people of click here African ancestry suggestive of genetic predisposition. The APOL1 G1 and G2 alleles are more strongly associated with the risk for HIVAN than the previously reported MYH9 E1 risk haplotype in individuals of African ancestry. The high prevalence of HIVAN among individuals of African ancestry could be a result of high frequencies of APOL1 risk variants as well as the prevalence of HIV-1 subtypes and modifying factors or second hits underlying the pathogenesis of kidney disease. INTRODUCTION Chronic kidney disease (CKD) is a major public health problem worldwide[1]. Mortality due to CKD nearly doubled worldwide between 1990 and 2010, and is now positioned at 18th as a cause of death in the Global Burden of Disease Study[2] and at 5th position in South Africa[3]. An estimated 3.2 million people were on renal replacement therapy by the end of 2013, approximately 2522000 people undergoing dialysis treatment (haemodialysis or peritoneal dialysis) and 678000 people living with renal transplants[4] and it is also estimated that Ion Channel Ligand Library ic50 CKD incidence grows by approximately 6% annually[4]. There are striking ethnic differences in the prevalence of CKD such that, in the United States, African Americans have the highest prevalence of CKD[5]. Diabetes and hypertension, which have been considered the two leading causes of CKD, together with differences in clinical, social-demographic or lifestyle factors, are insufficient to account satisfactorily for the excess risk of end stage renal disease (ESRD) in African Americans[6,7]. Africa, the second largest and the world��s second most populous continent, is approximately 30.2 million square km2 and composed of 54 countries[8] and more than 1.1 billion people as of 2013, accounting for 15% of the world��s population[9]. It has been postulated that, by 2030, approximately 70% of the patients with ESRD will be living in low income countries such as those in sub-Saharan Africa where majority of people live on less than one dollar-a-day[10,11].