Janus Kinase-STAT Inhibition to Reduce APOL1 Associated Kidney Disease

Inclusion Criteria: * Adults 18-70 years * High Risk APOL1 genotype (i.e., G1G1, G2G2, or G1G2) * FSGS diagnosed by kidney biopsy or clinically diagnosed HTN-CKD * UACR ≥300 mg/dL * Estimated glomerular filtration rate (eGFR) ≥26 ml/min/1.73 m2 at screening * Stable antihypertensive regimen for ≥ 1 month prior to enrolment * Able to provide written informed consent Exclusion Criteria: * Diabetes * HIV * Sickle cell disease. * Tip variant of FSGS. * Systolic BP \>180 mmHg or diastolic BP \>90 mmHg based on average of 3 measurements. * Active serious viral, bacterial, fungal or parasitic infection. * Symptomatic herpes zoster infection within 12 weeks prior to study entry. * Positive hepatitis B surface antigen during screening (could enroll after treatment). * Previous kidney transplant. * History of chronic liver disease with the most recent available aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \>1.5 times the ULN or the most recent available total bilirubin ≥1.5 times the ULN * Hemoglobin \<10 g/dL. * Absolute lymphocyte count (ALC)\<500cells/mm3 or absolute neutrophil count (ANC) \< 1000 cells/mm3. * Pregnant or nursing at time of enrollment * Prior or current treatment with JAK inhibitor. * Current use of potent immunosuppressants such as abatacept, adalimumab, anakinra, azathioprine, certolizumab, etanercept, golimumab, infliximab, probenecid, rituximab, ruxolitinib, sarilumab, tofacitinib, or tocilizumab. * High dose corticosteroids (\>10 mg per day of prednisone or equivalent) or an unstable dosing regimen of corticosteroids within 2 weeks of study entry or within 6 weeks of planned randomization.