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Any nephrologist practicing in the U.S. does not need to be told that there is an increased incidence of end-stage renal disease in blacks. Furthermore, certain diseases–such as collapsing focal segmental glomerulosclerosis (FSGS), occur almost exclusively in black populations.

In the most recent issue of Nature Genetics, two different groups (Kopp et al; Kao et al) have identified a gene which may help to explain some of the increased prevalence of renal disease and FSGS in black populations. Using various genetic techniques, both groups independently identified polymorphisms in the gene MYH9 (a myosin heavy chain isoform on chromosome 22 which is expressed in podocytes) which predispose to (a) FSGS in blacks, and (b) non-diabetic causes of end-stage renal disease.

Perhaps in the future, genotyping of MYH9 and similar genes could allow an identification of which patients are most at-risk for developing ESRD.

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