A recent review in CJASN discusses the concept of MYH9 Nephropathies. In the African American population, we have always observed many kidney diseases. Research at Wake Forrest Medical Center has revealed some excellent genetic findings. Polymorphisms in the non muscle myosin heavy chain 9 gene (MYH9) has been associated with many non diabetic kidney diseases seen in African and European derived american populations. Turns out that 45% of the ESRD groups in the African Americans have this risk variant.
There must be a second hit to take this disease to occur. What is proposed in the summary is that perhaps:
there is the first hit, the RISK, then there is this second hit: either gene interaction, environmental factors such as a virus like HIV --> then leading to kidney disease and severe hypertension. The pathology spectrum is collapsing FSGS, FSGS and focal global sclerosis.
Have a look at the summary.
http://www.ncbi.nlm.nih.gov/pubmed/20299374
Other references
http://www.ncbi.nlm.nih.gov/pubmed/20532800
http://www.ncbi.nlm.nih.gov/pubmed/20523037
http://www.ncbi.nlm.nih.gov/pubmed/20492585
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