Individuals with APOL1 high-risk genotypes possess 2 renal risk variants (RRVs) and generally have faster declines in eGFR than those with low-risk genotypes (0/1 RRV). However, genotypes may not predict outcomes in a given patient.1,2 Before the APOL1 discovery, family history of ESKD was a recognized CKD risk factor in African Americans.3