Virginia Via Research Day Book 2026

Medical Student Research Clinical

EXAMINING THE EFFECT OF APOL1 RISK ALLELE POSITIVITY ON POSTOPERATIVE OUTCOMES IN CKD NEGATIVE PATIENTS

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Rebecca El Choueiry, OMS-II; David Grace, OMS-II; Jerome Gerges, OMS-II; Arundhati Rajpurohit, OMS-II Corresponding author:relchoueiry@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

Context: The risk of developing chronic kidney disease (CKD) is increased in patients carrying APOL1 risk alleles, characterized as G1 and G2. According to the current literature, carriers of the G1 and G2 risk alleles have a roughly 20% chance of developing CKD (Beckerman & Susztak, 2018). It is well documented that patients with CKD are at a greater risk of postoperative morbidity and mortality; however, little is known about postoperative outcomes in patients possessing the APOL1 risk alleles who have not developed chronic kidney disease (Liao et. al., 2023). Objective and/or Hypothesis: Understanding the effect of APOL1 risk alleles on postoperative outcomes in patients without CKD could improve risk stratification, guide patient counseling, and inform postoperative planning for individuals of African ancestry, who disproportionately carry APOL1 risk variants. By clarifying genetic contributions to postoperative complications, this research has the potential to reduce disparities, improve surgical outcomes, and support more equitable, evidence-based guidelines in postoperative care.

Methods: This study will utilize the All of Us Research database, which integrates genomic data with linked electronic health records (EHRs), to identify individuals with APOL1 high-risk variants without CKD. We will compare adverse postoperative outcomes between surgical patients with and without the APOL1 risk alleles, adjusting for age, sex, comorbidities, and type of surgery. Standard statistical methods (multivariable regression and survival analysis) will be applied within All of Us using related analytic tools. This approach will allow us to explore whether surgical patients with the APOL1 risk alleles possess additional postoperative risk beyond wild-type APOL1 carriers, with implications for risk stratification and surgical planning. Results: The expected outcome of this study is to demonstrate whether the APOL1 risk variants are associated with an increased likelihood of adverse postoperative outcomes. The significance of this work lies in its potential to improve postoperative counseling, allowing clinicians to better inform patients about surgical risks and anticipate complications.

Conclusion(s): The results will show whether the APOL1 risk alleles in patients without evidence of CKD influence postoperative outcomes in the absence of other comorbidities. IRB Statement: IRB Approval Pending

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197 2026 Research Recognition Day