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Schönauer R, Baatz S, Nemitz-Kliemchen M, Frank V, Petzold F, Sewerin S, Popp B, Münch J, Neuber S, Bergmann C, Halbritter J. Matching clinical and genetic diagnoses in autosomal dominant polycystic kidney disease reveals novel phenocopies and potential candidate genes. Genet Med 2020; 22:1374-1383. [PMID: 32398770 PMCID: PMC7394878 DOI: 10.1038/s41436-020-0816-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/07/2020] [Accepted: 04/17/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose Autosomal dominant polycystic kidney disease (ADPKD) represents the most common hereditary nephropathy. Despite growing evidence for genetic heterogeneity, ADPKD diagnosis is still primarily based upon clinical imaging criteria established before discovery of additional PKD genes. This study aimed at assessing the diagnostic value of genetic verification in clinical ADPKD. Methods In this prospective, diagnostic trial, 100 families with clinically diagnosed ADPKD were analyzed by PKD gene panel and multiplex ligation-dependent probe amplification (MLPA); exome sequencing (ES) was performed in panel/MLPA-negative families. Results Diagnostic PKD1/2 variants were identified in 81 families (81%), 70 of which in PKD1 and 11 in PKD2. PKD1 variants of unknown significance were detected in another 9 families (9%). Renal survival was significantly worse upon PKD1 truncation versus nontruncation and PKD2 alteration. Ten percent of the cohort were PKD1/2-negative, revealing alternative genetic diagnoses such as autosomal recessive PKD, Birt–Hogg–Dubé syndrome, and ALG9-associated PKD. In addition, among unsolved cases, ES yielded potential novel PKD candidates. Conclusion By illustrating vast genetic heterogeneity, this study demonstrates the value of genetic testing in a real-world PKD cohort by diagnostic verification, falsification, and disease prediction. In the era of specific treatment for fast progressive ADPKD, genetic confirmation should form the basis of personalized patient care.
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Affiliation(s)
- Ria Schönauer
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Sebastian Baatz
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Melanie Nemitz-Kliemchen
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Valeska Frank
- Institute of Human Genetics, Bioscientia, Ingelheim, Germany.,Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany
| | - Friederike Petzold
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Sebastian Sewerin
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Bernt Popp
- Institute of Human Genetics, University of Leipzig, Leipzig, Germany
| | - Johannes Münch
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Steffen Neuber
- Institute of Human Genetics, Bioscientia, Ingelheim, Germany
| | - Carsten Bergmann
- Institute of Human Genetics, Bioscientia, Ingelheim, Germany.,Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany.,Department of Medicine, Division of Nephrology, University Hospital Freiburg, Freiburg, Germany
| | - Jan Halbritter
- Department of Internal Medicine, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany.
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Baatz S. The campaign for reform: medical education and professional improvement in antebellum America. Trans Stud Coll Physicians Phila 1999; 21:118-48. [PMID: 10741218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- S Baatz
- History Department, Central Connecticut State University, New Britain, USA
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Baatz S. Peaceful Triumphs:
Magnificent Voyagers
. The U.S. Exploring Expedition, 1838-1842. Herman J. Viola and Carolyn Margolis, Eds. Smithsonian Institution Press, Washington, DC, 1985. 303 pp., illus. $39.95; paper, $19.95. Science 1986; 232:1020. [PMID: 17759294 DOI: 10.1126/science.232.4753.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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