Phenotypic spectrum of children with nephronophthisis and related ciliopathies

Background and objectives: Genetic heterogeneity and phenotypic variability are major challenges in familial nephronophthisis and related ciliopathies. To date, mutations in 20 different genes (NPHP1 to -20) have been identified causing either isolated kidney disease or complex multiorgan disorders....

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Hauptverfasser: König, Jens (VerfasserIn) , Gretz, Norbert (VerfasserIn) , Lablans, Martin (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 7, 2017
In: Clinical journal of the American Society of Nephrology
Year: 2017, Jahrgang: 12, Heft: 12, Pages: 1974-1983
ISSN:1555-905X
DOI:10.2215/CJN.01280217
Online-Zugang:Verlag, teilw. kostenfrei, Volltext: http://dx.doi.org/10.2215/CJN.01280217
Verlag, teilw. kostenfrei, Volltext: https://cjasn-asnjournals-org.ezproxy.medma.uni-heidelberg.de/content/12/12/1974
Volltext
Verfasserangaben:Jens König, Birgitta Kranz, Sabine König, Karl Peter Schlingmann, Andrea Titieni, Burkhard Tönshoff, Sandra Habbig, Lars Pape, Karsten Häffner, Matthias Hansen, Anja Büscher, Martin Bald, Heiko Billing, Raphael Schild, Ulrike Walden, Tobias Hampel, Hagen Staude, Magdalena Riedl, Norbert Gretz, Martin Lablans, Carsten Bergmann, Friedhelm Hildebrandt, Heymut Omran, Martin Konrad

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245 1 0 |a Phenotypic spectrum of children with nephronophthisis and related ciliopathies  |c Jens König, Birgitta Kranz, Sabine König, Karl Peter Schlingmann, Andrea Titieni, Burkhard Tönshoff, Sandra Habbig, Lars Pape, Karsten Häffner, Matthias Hansen, Anja Büscher, Martin Bald, Heiko Billing, Raphael Schild, Ulrike Walden, Tobias Hampel, Hagen Staude, Magdalena Riedl, Norbert Gretz, Martin Lablans, Carsten Bergmann, Friedhelm Hildebrandt, Heymut Omran, Martin Konrad 
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520 |a Background and objectives: Genetic heterogeneity and phenotypic variability are major challenges in familial nephronophthisis and related ciliopathies. To date, mutations in 20 different genes (NPHP1 to -20) have been identified causing either isolated kidney disease or complex multiorgan disorders. In this study, we provide a comprehensive and detailed characterization of 152 children with a special focus on extrarenal organ involvement and the long-term development of ESRD. Design, setting, participants, & measurements: We established an online-based registry (www.nephreg.de) to assess the clinical course of patients with nephronophthisis and related ciliopathies on a yearly base. Cross-sectional and longitudinal data were collected. Mean observation time was 7.5±6.1 years. Results: In total, 51% of the children presented with isolated nephronophthisis, whereas the other 49% exhibited related ciliopathies. Monogenetic defects were identified in 97 of 152 patients, 89 affecting NPHP genes. Eight patients carried mutations in other genes related to cystic kidney diseases. A homozygous NPHP1 deletion was, by far, the most frequent genetic defect (n=60). We observed a high prevalence of extrarenal manifestations (23% [14 of 60] for the NPHP1 group and 66% [61 of 92] for children without NPHP1). A homozygous NPHP1 deletion not only led to juvenile nephronophthisis but also was able to present as a predominantly neurologic phenotype. However, irrespective of the initial clinical presentation, the kidney function of all patients carrying NPHP1 mutations declined rapidly between the ages of 8 and 16 years, with ESRD at a mean age of 11.4±2.4 years. In contrast within the non-NPHP1 group, there was no uniform pattern regarding the development of ESRD comprising patients with early onset and others preserving normal kidney function until adulthood. Conclusions: Mutations in NPHP genes cause a wide range of ciliopathies with multiorgan involvement and different clinical outcomes. 
650 4 |a Adolescent 
650 4 |a Bardet-Biedl syndrome 
650 4 |a Ciliopathies 
650 4 |a COACH syndrome 
650 4 |a Congenital oculomotor apraxia 
650 4 |a Cross-Sectional Studies 
650 4 |a Genetic Heterogeneity 
650 4 |a Homozygote 
650 4 |a Joubert-like syndromes 
650 4 |a Kidney Diseases, Cystic 
650 4 |a Kidney Failure, Chronic 
650 4 |a Mainzer-Saldino syndrome 
650 4 |a Mutation 
650 4 |a NEPHREG registry 
650 4 |a Nephronophthisis (NPH) 
650 4 |a Nephronophthisis related ciliopathy 
650 4 |a Nephronophthisis, familial juvenile 
650 4 |a Prevalence 
650 4 |a Registries 
650 4 |a Senior-Løken syndrome 
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