Genetic Architecture of Childhood Kidney and Urological Diseases in China.

IF 3.7 Q2 GENETICS & HEREDITY Phenomics (Cham, Switzerland) Pub Date : 2021-06-01 DOI:10.1007/s43657-021-00014-1
Ye Fang, Hua Shi, Tianchao Xiang, Jiaojiao Liu, Jialu Liu, Xiaoshan Tang, Xiaoyan Fang, Jing Chen, Yihui Zhai, Qian Shen, Guomin Li, Li Sun, Yunli Bi, Xiang Wang, Yanyan Qian, Bingbing Wu, Huijun Wang, Wenhao Zhou, Duan Ma, Jianhua Mao, Xiaoyun Jiang, Shuzhen Sun, Ying Shen, Xiaorong Liu, Aihua Zhang, Xiaowen Wang, Wenyan Huang, Qiu Li, Mo Wang, Xiaojie Gao, Yubin Wu, Fang Deng, Ruifeng Zhang, Cuihua Liu, Li Yu, Jieqiu Zhuang, Qing Sun, Xiqiang Dang, Haitao Bai, Ying Zhu, Siguang Lu, Bili Zhang, Xiaoshan Shao, Xuemei Liu, Mei Han, Lijun Zhao, Yuling Liu, Jian Gao, Ying Bao, Dongfeng Zhang, Qingshan Ma, Liping Zhao, Zhengkun Xia, Biao Lu, Yulong Wang, Mengzhun Zhao, Jianjiang Zhang, Shan Jian, Guohua He, Huifeng Zhang, Bo Zhao, Xiaohua Li, Feiyan Wang, Yufeng Li, Hongtao Zhu, Xinhui Luo, Jinghai Li, Jia Rao, Hong Xu
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引用次数: 5

Abstract

Kidney disease is manifested in a wide variety of phenotypes, many of which have an important hereditary component. To delineate the genotypic and phenotypic spectrum of pediatric nephropathy, a multicenter registration system is being implemented based on the Chinese Children Genetic Kidney Disease Database (CCGKDD). In this study, all the patients with kidney and urological diseases were recruited from 2014 to 2020. Genetic analysis was conducted using exome sequencing for families with multiple affected individuals with nephropathy or clinical suspicion of a genetic kidney disease owing to early-onset or extrarenal features. The genetic diagnosis was confirmed in 883 of 2256 (39.1%) patients from 23 provinces in China. Phenotypic profiles showed that the primary diagnosis included steroid-resistant nephrotic syndrome (SRNS, 23.5%), glomerulonephritis (GN, 32.2%), congenital anomalies of the kidney and urinary tract (CAKUT, 21.2%), cystic renal disease (3.9%), renal calcinosis/stone (3.6%), tubulopathy (9.7%), and chronic kidney disease of unknown etiology (CKDu, 5.8%). The pathogenic variants of 105 monogenetic disorders were identified. Ten distinct genomic disorders were identified as pathogenic copy number variants (CNVs) in 11 patients. The diagnostic yield differed by subgroups, and was highest in those with cystic renal disease (66.3%), followed by tubulopathy (58.4%), GN (57.7%), CKDu (43.5%), SRNS (29.2%), renal calcinosis /stone (29.3%) and CAKUT (8.6%). Reverse phenotyping permitted correct identification in 40 cases with clinical reassessment and unexpected genetic conditions. We present the results of the largest cohort of children with kidney disease in China where diagnostic exome sequencing was performed. Our data demonstrate the utility of family-based exome sequencing, and indicate that the combined analysis of genotype and phenotype based on the national patient registry is pivotal to the genetic diagnosis of kidney disease.

Supplementary information: The online version contains supplementary material available at 10.1007/s43657-021-00014-1.

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中国儿童肾脏和泌尿系统疾病的遗传结构。
肾脏疾病表现为各种各样的表型,其中许多具有重要的遗传成分。为了描述儿童肾病的基因型和表型谱,基于中国儿童遗传肾病数据库(CCGKDD)的多中心注册系统正在实施。本研究招募2014 - 2020年所有肾脏及泌尿系统疾病患者。遗传学分析采用外显子组测序方法,对患有肾病或因早发性或肾外特征而临床怀疑患有遗传性肾病的多个受影响个体的家庭进行。来自中国23个省份的2256例患者中有883例(39.1%)被确诊为遗传诊断。表型分析显示,主要诊断为类固醇抵抗性肾病综合征(SRNS, 23.5%)、肾小球肾炎(GN, 32.2%)、先天性肾脏和尿路异常(CAKUT, 21.2%)、囊性肾病(3.9%)、肾钙质沉着症/结石(3.6%)、肾小管病变(9.7%)和病因不明的慢性肾病(CKDu, 5.8%)。鉴定了105种单遗传疾病的致病变异。在11例患者中鉴定出10种不同的基因组疾病为致病性拷贝数变异(CNVs)。不同亚组的诊断率不同,其中囊性肾病的诊断率最高(66.3%),其次是小管病(58.4%)、GN(57.7%)、CKDu(43.5%)、SRNS(29.2%)、肾钙质沉着症/结石(29.3%)和ckut(8.6%)。反向表型允许正确识别40例临床重新评估和意外的遗传条件。我们介绍了在中国进行诊断外显子组测序的最大的肾脏疾病儿童队列的结果。我们的数据证明了基于家族的外显子组测序的实用性,并表明基于国家患者登记的基因型和表型的联合分析对肾脏疾病的遗传诊断至关重要。补充资料:在线版本提供补充资料,网址为10.1007/s43657-021-00014-1。
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