APOL1 and Preeclampsia: Intriguing Links, Uncertain Causality, Troubling Implications

Preeclampsia is a common, serious, multisystem disorder of pregnancy characterized by hypertension onset after 20 weeks of gestation (or worsening of hypertension in a patient with chronic hypertension) and onset or worsening of proteinuria.1 Data from the National Inpatient Sample showed approximately 177,000 of 3.8 million deliveries (4.7%) have a diagnosis of preeclampsia/eclampsia.2 This disorder is of interest to nephrologists, since women with chronic kidney disease (CKD) are at increased risk to develop preeclampsia and kidney physicians are often consulted to help manage their blood pressure and kidney manifestations.