Genetic Testing to Understand and Address Renal Disease Disparities Across the United States Pharmacogenetic Substudy

Prior treatment

• Are currently on dialysis (ICD 10 codes N18.6, Z99.2 and Z94.0)
• Have had a liver, kidney, or allogeneic bone marrow transplant
• Previously participated in the GUARDD pilot study OR have previously undergone APOL1 testing

Other illness

• Have diabetes, but no CKD.
• Have a terminal illness
• Institutionalized or too ill to participate (i.e. incarcerated, psychiatric or nursing home facility)
• Not a current patient seeing a provider who cares for their hypertension (i.e., family medicine, internal medicine, nephrology, HIV provider, cardiology, hypertension specialists) at a participating site

Lab values

• Have ESRD (eGFR\<15 ml/min)

Other

• Have a left ventricular assist device (LVAD)
• Have patient-reported known pregnancy at time of enrollment
• Too cognitively impaired to provide informed consent and/or complete the study protocol
• Plan to move out of the area within 6 months of enrollment

• Self reported African ancestry
• English Speaking
• Age 18-70 years
• Have diagnosis of hypertension: Diagnosis of hypertension is defined by either:
  • ICD10 diagnosis codes (i.e., I10; I11.x; I12.x; I13.x; I16.x) OR
  • On active antihypertensive therapy for indication of hypertension OR
  • Having systolic blood pressure of 140 mm Hg or greater in at least 2 of the last 3 consecutive recorded values in the EHR OR
  • Having hypertension in the patient's medical record problem list
• Have been seen at ≥1 time in past year at a participating primary care site
• Either: 1) do not have diabetes and do not have CKD, or 2) have CKD; Participants with diabetes may be included as long as they also have CKD.
  • CKD is defined by either: A) ICD10 codes (i.e., N18.x; E08.22; E09.22; E10.22; E11.22;E13.22 (exclude Z94.0; N18.6; Z99.2)) OR B) Microalbumin/proteinuria level \>30 mg/g for 2 time periods ≥ 3 months. Values taken within 12 months of enrollment, unless 2 values are unavailable, then review within 24 months of enrollment. OR C) 15 ≤ eGFR ≤ 60 ml/min for 2 time periods ≥ 3 months. GFRs are taken within 12 months of enrollment, unless 2 values are unavailable, then review within 24 months.
  • Diabetes is defined by: HbA1c ≥ 6.5 at least one time in the last year OR ICD10 diagnosis codes OR Having diabetes in the patient's medical record problem list.