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Pediatr Nephrol. 2019 Aug;34(8):1457-1464. doi: 10.1007/s00467-019-04230-w. Epub 2019 Apr 1.

Association between the clinical presentation of congenital anomalies of the kidney and urinary tract (CAKUT) and gene mutations: an analysis of 66 patients at a single institution.

Author information

1
Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
2
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
3
Division of Medical Genetics, National Center for Child Health and Development, Tokyo, Japan.
4
Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
5
Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. kenzo@ii.e-mansion.com.

Abstract

BACKGROUND:

The association between the clinical presentation of congenital anomalies of the kidney and urinary tract (CAKUT) and gene mutations has yet to be fully explored.

METHODS:

In this retrospective cohort study, we examined patients with CAKUT who underwent gene analysis. The analysis was performed in patients with bilateral renal lesions, extrarenal complications, or a family history of renal disease. The data from the diagnosis, gene mutations, and other complications were analyzed.

RESULTS:

In total, 66 patients with CAKUT were included. Of these, gene mutations were detected in 14 patients. Bilateral renal lesions were significantly related to the identification of gene mutations (p = 0.02), and no gene mutations were observed in patients with lower urinary tract obstruction (six patients). There was no significant difference in the rate of gene mutations between those with or without extrarenal complications (p = 0.76). The HNF1β gene mutation was identified in most of the patients with hypodysplastic kidney with multicystic dysplastic kidney (six of seven patients). There was no significant difference in the presence or absence of gene mutations with respect to the renal survival rate (log-rank test p = 0.53). The renal prognosis varied, but the differences were not statistically significant for any of the gene mutations.

CONCLUSIONS:

CAKUT with bilateral renal lesions were significantly related to gene mutations. We recommend that CAKUT-related gene analysis be considered in cases of bilateral renal lesions. No gene mutations were observed in patients with lower urinary tract obstruction. The renal prognosis varied for each gene mutation.

KEYWORDS:

CAKUT (congenital anomalies of the kidney and urinary tract); CKD (chronic kidney disease); Children; ESKD (end stage kidney disease); Gene mutation

PMID:
30937553
DOI:
10.1007/s00467-019-04230-w

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