President and CEO Jay S. Feldstein, DO '81, was joined recently by Daryl O. Crenshaw, MD, FACP, FASN, FASH, an adjunct faculty member at PCOM South Georgia, a practicing nephrologist, and an avid supporter of medical education. On the PCOM Perspectives podcast, they discuss kidney concerns impacting Georgia's population and how new technology can help.
Play PCOM Perspectives: Legacy of Healing
Growing up in rural Selma, Alabama, Crenshaw witnessed his family members struggle
with kidney disease. He specifically recalls the 1970s, when his uncle required dialysis
and received a transplant. Later on, he'd lose his grandmother to end-stage kidney
disease.
“I really did not like it,” he said. “My uncle actually died at the age of 39.”
Through the losses, Crenshaw was able to develop a special relationship and fondness for the kidney throughout his time in medical school. He connected his own experiences to what others were facing and moved towards a full-time career in nephrology.
“All throughout the South, I recognized that there was a tremendous burden of kidney disease. I think this propelled me to pursue my aspirations of becoming a nephrologist,” he shared.
As Crenshaw trained in Atlanta, he saw the impact of the disease in his training. In Georgia, the mortality rate of kidney disease is 30-40% higher than the national average.
He then decided to move somewhere that was endemic to kidney disease. Now living in South Georgia, Crenshaw is working with new technology to help identify patients likely to develop kidney failure.
“The two most common causes of kidney disease are diabetes and hypertension. When you look at the combination of diabetes and hypertension, that comprises about 75% of all people with the disease,” he said. “What has been revealed within the last few years is the genetic component that’s affiliated with kidney disease.”
This genetic component, known as APOL-1, is identified in African Americans as a high-risk allele variant in sub-Saharan Africa. This means that the variant is not expected to directly cause a genetic condition on its own, but it can lead to an increased risk or predisposition to develop kidney disease, if two high risk alleles are present.
Crenshaw notes that many of the ancestors who had this particular variant allele passed it to their descendants.
“There's a large percentage of African Americans who carry this high-risk allele of APOL-1,” he said. “Perhaps there's been a misattribution to hypertension when they actually have this genetic component causing kidney disease.”
Thanks to the new research, doctors can now test for the gene with a swab of the cheek. Because of this progress, Crenshaw believes there's a chance for treatments to come down the pipeline that can target and mitigate the risk of kidney disease, particularly in African Americans and those with African ancestry. An effort that will help many.
To hear the full conversation or listen to past episodes of PCOM Perspectives, visit the College's Spotify page or search “Philadelphia College of Osteopathic Medicine” anywhere you get your podcasts.
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