Abstract
Background and objectives Steroid-resistant nephrotic syndrome overwhelmingly progresses to ESRD. More than 30 monogenic genes have been identified to cause steroid-resistant nephrotic syndrome. We previously detected causative mutations using targeted panel sequencing in 30% of patients with steroid-resistant nephrotic syndrome. Panel sequencing has a number of limitations when compared with whole exome sequencing. We employed whole exome sequencing to detect monogenic causes of steroid-resistant nephrotic syndrome in an international cohort of 300 families. Design, setting, participants, & measurements Three hundred thirty-five individuals with steroid-resistant nephrotic syndrome from 300 families were recruited from April of 1998 to June of 2016. Age of onset was restricted to <25 years of age. Exome data were evaluated for 33 known monogenic steroid-resistant nephrotic syndrome genes. Results In 74 of 300 families (25%), we identified a causative mutation in one of 20 genes known to cause steroid-resistant nephrotic syndrome. In 11 families (3.7%), we detected a mutation in a gene that causes a phenocopy of steroid-resistant nephrotic syndrome. This is consistent with our previously published identification of mutations using a panel approach. We detected a causative mutation in a known steroid-resistant nephrotic syndrome gene in 38% of consanguineous families and in 13% of nonconsanguineous families, and 48% of children with congenital nephrotic syndrome. A total of 68 different mutations were detected in 20 of 33 steroid-resistant nephrotic syndrome genes. Fifteen of these mutations were novel. NPHS1, PLCE1, NPHS2, and SMARCAL1 were the most common genes in which we detected a mutation. In another 28% of families, we detected mutations in one or more candidate genes for steroid-resistant nephrotic syndrome. Conclusions Whole exome sequencing is a sensitive approach toward diagnosis of monogenic causes of steroid-resistant nephrotic syndrome. A molecular genetic diagnosis of steroid-resistant nephrotic syndrome may have important consequences for the management of treatment and kidney transplantation in steroid-resistant nephrotic syndrome.
Original language | English |
---|---|
Pages (from-to) | 53-62 |
Number of pages | 10 |
Journal | Clinical Journal of the American Society of Nephrology |
Volume | 13 |
Issue number | 1 |
DOIs | |
State | Published - 6 Jan 2018 |
Funding
Funders | Funder number |
---|---|
FP7/2007 | 2012-305608 |
Ii-numa-Tsuchiya Foundation for Overseas Research | |
Manton Center for Orphan Diseases Research | VE 916/1-1 |
National Institutes of Health | DK007726-31A1, DK076683, T32-AR053461-04, U54 HG006504 |
National Institutes of Health | |
National Institute of Diabetes and Digestive and Kidney Diseases | ZIADK043308, FP01014311 |
National Institute of Diabetes and Digestive and Kidney Diseases | |
National Academy of Sciences | LPDS-2015-07 |
National Academy of Sciences | |
American Society of Nephrology | |
California Department of Fish and Game | |
Seventh Framework Programme | |
Deutsche Forschungsgemeinschaft | HE 7456/1-1, Jo 1324/1-1 |
Deutsche Forschungsgemeinschaft | |
National Research Foundation of Korea | 2015R1D1A1A01056685 |
National Research Foundation of Korea | |
Seventh Framework Programme | |
Hacettepe Üniversitesi | 06A101008 |
Hacettepe Üniversitesi | |
Deutsche Akademie der Naturforscher Leopoldina - Nationale Akademie der Wissenschaften |
Keywords
- Child
- Exome
- Genetic renal disease
- Humans
- Kidney failure, chronic
- Kidney transplantation
- Molecular genetics
- Mutation
- Nephrosis, congenital
- Nephrotic syndrome
- Pediatric
- Phenotype
- Renal insufficiency, chronic