Towards Equitable Nephrology: Genetic Insights Via Single Nucleotide Polymorphisms In Glutathione Peroxidase Genes Within Hispanic Cohorts With Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is an imminent public health crisis posing a disproportionate threat to Hispanic populations. While previous studies have acknowledged environmental and lifestyle risks contributing to CKD, there remains a critical gap in literature regarding the role of oxidative stress in genetic susceptibility in this population. This study investigated the interplay of oxidative stress and genome-wide susceptibility to CKD through a genome-wide association study (GWAS) by seeking to identify single nucleotide polymorphisms (SNPs) within the glutathione peroxidase (GPX) gene family thought to be involved in renal protection from reactive oxygen species (ROS). No significant SNP associations were found within the GPX gene family; however, candidate SNPs were identified. Given the inextricable link between disease and systemic oppression, the 2024 Dialysis Facility Report was used to evaluate healthcare disparities in ESRD treatment between Medicaid expansion and non-expansion states while quantifying Hispanic representation. Findings reveal significant disparities in CKD prevalence outcomes for Hispanics which could be attributed to historical oppression in the field of nephrology and barriers to receiving care leading to late diagnosis. This research supports a pivot in nephrology that accepts preventative strategies and structural change. Advancing health equity in renal care strongly supports inclusive genomics, expanding Medicaid, instituting screening programs and simultaneously dismantling institutional inequities to guarantee rigorous healthcare in all at-risk populations.