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ABSTRACT: Background and aims
Genetic testing presents a unique opportunity for diagnosis and management of genetic kidney diseases (GKD). Here, we describe the clinical utility and valuable impact of a specialized GKD clinic, which uses a variety of genomic sequencing strategies.Methods
In this prospective cohort study, we undertook genetic testing in adults with suspected GKD according to prespecified criteria. Over 7 years, patients were referred from tertiary centres across Ireland to an academic medical centre as part of the Irish Kidney Gene Project.Results
Among 677 patients, the mean age was of 37.2 ± 13 years, and 73.9% of the patients had family history of chronic kidney disease (CKD). We achieved a molecular diagnostic rate of 50.9%. Four genes accounted for more than 70% of identified pathogenic variants: PKD1 and PKD2 (n = 186, 53.4%), MUC1 (8.9%), and COL4A5 (8.3%). In 162 patients with a genetic diagnosis, excluding PKD1/PKD2, the a priori diagnosis was confirmed in 58% and in 13% the diagnosis was reclassified. A genetic diagnosis was established in 22 (29.7%) patients with CKD of uncertain aetiology. Based on genetic testing, a diagnostic kidney biopsy was unnecessary in 13 (8%) patients. Presence of family history of CKD and the underlying a priori diagnosis were independent predictors (P < 0.001) of a positive genetic diagnosis.Conclusions
A dedicated GKD clinic is a valuable resource, and its implementation of various genomic strategies has resulted in a direct, demonstrable clinical and therapeutic benefits to affected patients.
SUBMITTER: Elhassan EAE
PROVIDER: S-EPMC9300532 | biostudies-literature | 2022 Jul
REPOSITORIES: biostudies-literature
Elhassan Elhussein A E EAE Murray Susan L SL Connaughton Dervla M DM Kennedy Claire C Cormican Sarah S Cowhig Cliona C Stapleton Caragh C Little Mark A MA Kidd Kendrah K Bleyer Anthony J AJ Živná Martina M Kmoch Stanislav S Fennelly Neil K NK Doyle Brendan B Dorman Anthony A Griffin Matthew D MD Casserly Liam L Harris Peter C PC Hildebrandt Friedhelm F Cavalleri Gianpiero L GL Benson Katherine A KA Conlon Peter J PJ
Journal of nephrology 20220131 6
<h4>Background and aims</h4>Genetic testing presents a unique opportunity for diagnosis and management of genetic kidney diseases (GKD). Here, we describe the clinical utility and valuable impact of a specialized GKD clinic, which uses a variety of genomic sequencing strategies.<h4>Methods</h4>In this prospective cohort study, we undertook genetic testing in adults with suspected GKD according to prespecified criteria. Over 7 years, patients were referred from tertiary centres across Ireland to ...[more]