Deciphering the mutation spectrum in south Indian children with congenital anomalies of the kidney and urinary tract

BMC Nephrology

Arpana Iyengar¹  A. M. Shubha²  Varsha Chhotusing Pardeshi³  Ambili Narikot³  Anil Vasudevan⁴ 

[1] Department of Pediatric Nephrology, St. John’s Medical College, 560034, Bengaluru, India;Department of Pediatric Surgery, St. John’s Medical College, Bengaluru, India;Divsion of Molecular Medicine, St. John’s Research Institute, St. John’s Medical College, Bengaluru, India;Divsion of Molecular Medicine, St. John’s Research Institute, St. John’s Medical College, Bengaluru, India;Department of Pediatric Nephrology, St. John’s Medical College, 560034, Bengaluru, India;

关键词: CAKUT;    Genetics;    Next generation sequencing;    Variants;    Monogenic;   

DOI  :  10.1186/s12882-021-02628-z

来源: Springer

【 摘 要 】

BackgroundCongenital anomalies of the kidney and urinary tract (CAKUT) cover a spectrum of structural malformations that result from aberrant morphogenesis of kidney and urinary tract. It is the most prevalent cause of kidney failure in children. Hence, it is important from a clinical perspective to unravel the molecular etiology of kidney and urinary tract malformations. Causal variants in genes that direct various stages of development of kidney and urinary tract in fetal life have been identified in 5–20% of CAKUT patients from Western countries. Recent advances in next generation sequencing technology and decreasing cost offer the opportunity to characterize the genetic profile of CAKUT in Indian population and facilitate integration of genetic diagnostics in care of children with CAKUT.MethodsCustomized targeted panel sequencing was performed to identify pathogenic variants in 31 genes known to cause human CAKUT in 69 south Indian children with CAKUT. The NGS data was filtered using standardized pipeline and the variants were classified using ACMG criteria. Genotype and phenotype correlations were performed.ResultsThe cohort consisted of children mostly with posterior urethral valve (PUV) (39.1%), vesico-ureteric reflux (VUR) (33.3%) and multi-cystic dysplastic kidney (MCDK) (7.2%). No pathogenic or likely pathogenic variants were identified in the study. Most of our variants (n = 39, 60%) were variants of unknown significance with 25.6% (10/39) of them were identified as potentially damaging but were novel variants.ConclusionsThe present study did not identify any disease-causing monogenic variants in the cohort. The absence of genetic cause may be due to limitations of panel-based testing and also due to higher proportion of children with abnormalities in lower urinary tract than hypodysplasia of kidneys. Clinical, larger targeted panel or whole exome sequencing may be a better method to characterize the genetic profile of Indians patients with CAKUT.

【 授权许可】

CC BY