Chronic kidney disease (CKD) is responsible for a public health burden with multi-systemic complications. Through trans-ancestry meta-analysis of genome-wide association studies of estimated glomerular filtration rate (eGFR) and independent replication (n = 1,046,070), we identified 264 associated loci (166 new). Of these, 147 were likely to be relevant for kidney function on the basis of associations with the alternative kidney function marker blood urea nitrogen (n = 416,178). Pathway and enrichment analyses, including mouse models with renal phenotypes, support the kidney as the main target organ. A genetic risk score for lower eGFR was associated with clinically diagnosed CKD in 452,264 independent individuals. Colocalization analyses of associations with eGFR among 783,978 European-ancestry individuals and gene expression across 46 human tissues, including tubulo-interstitial and glomerular kidney compartments, identified 17 genes differentially expressed in kidney. Fine-mapping highlighted missense driver variants in 11 genes and kidney-specific regulatory variants. These results provide a comprehensive priority list of molecular targets for translational research.
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Genome-wide summary statistics for this study have been made publicly available at http://ckdgen.imbi.uni-freiburg.de.
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We thank D. Di Domizio (Eurac Research) and J. Knaus (University of Freiburg) for IT assistance and T. Johnson (GlaxoSmithKline) for sharing his code and discussion on credible set fine-mapping and colocalization analysis. This research has been conducted using the UK Biobank resource under application number 20272. Study-specific acknowledgements and funding sources are listed in the Supplementary Information.