HNF1B and PAX2 mutations are a common cause of renal hypodysplasia in the CKiD cohort.

HNF1B and PAX2 mutations are a common cause of renal hypodysplasia in the CKiD cohort.
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DOI:
10.1007/s00467-011-1826-9
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发表时间:
2011-06
影响因子:
3
通讯作者:
Gharavi, Ali G.
Gharavi, Ali G.
中科院分区:
医学3区
文献类型:
--
作者:
Thomas, Rosemary;Sanna-Cherchi, Simone;Warady, Bradley A.;Furth, Susan L.;Kaskel, Frederick J.;Gharavi, Ali G.

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肾脏和下尿路畸形是儿童终末期肾病的最常见原因。HNF 1B和PAX 2突变通常导致综合征性尿路畸形。我们在参加儿童慢性肾脏病队列研究(CKiD)的北美肾发育不全和发育不全(RHD)儿童中寻找HNF 1B和PAX 2的突变。我们在这个多种族队列中发现了7个突变(10%的患者)。在HNF 1B中,我们发现了一个无义突变(p.R181X)、一个错义突变(p.S148L)、一个移码突变(Y352 fsX 352)和一个全基因缺失。在PAX 2中,我们鉴定了一个剪接位点(IVS 4 -1G>T)、一个错义(p.G24E)和一个移码(G24 fsX 28)突变。所有突变均发生在高加索人中,占该亚组疾病的14%。其他种族中没有突变可能是由于样本量有限。有或无HNF 1B和PAX 2突变的患者之间的临床参数(年龄,基线eGFR,血压,体重指数,进展)没有差异。很大一部分北美白人RHD患者携带HNF 1B或PAX 2基因突变。应评估这些患者的并发症(例如HNF 1B突变的糖尿病,PAX 2的缺损),并转诊进行遗传咨询。
Malformations of the kidney and lower urinary tract are the most frequent cause of end stage renal disease in children. Mutations in HNF1B and PAX2 commonly cause of syndromic urinary tract malformation. We searched for mutations in HNF1B and PAX2 in North American children with renal aplasia and hypodysplasia (RHD) enrolled in the Chronic Kidney Disease in Children Cohort Study (CKiD). We identified 7 mutations in this multiethnic cohort (10% of patients). In HNF1B, we identified a nonsense (p.R181X), a missense (p.S148L), and a frameshift (Y352fsX352) mutation, and one whole gene deletion. In PAX2, we identified one splice site (IVS4–1G>T), one missense (p.G24E), and one frameshift (G24fsX28) mutation. All mutations occurred in Caucasians, accounting for 14% of disease in this subgroup. The absence of mutations in other ethnicities is likely due to limited sample size. There were no differences in clinical parameters (age, baseline eGFR, blood pressure, body mass index, progression) between patients with or without HNF1B and PAX2 mutations. A significant proportion of North American Caucasian patients with RHD carry mutations in HNF1B or PAX2 genes. These patients should be evaluated for complications (e.g. diabetes for HNF1B mutations, colobomas for PAX2) and referred for genetic counseling.
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