先天性肾、尿路异常的遗传基础

A. S. M. Nurunnabi, M. Hasan, A. Kaiser, Arif Mohammad, Shuchana Chakma
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摘要

先天性肾和尿路异常(先天性肾和尿路异常)是一组影响肾脏或尿路其他结构的异常,包括输尿管、膀胱和尿道。CAKUT包括肾发育不全或发育不良、多囊性肾发育不良、输尿管-肾盂连接处梗阻、骨盆、输尿管和/或肾脏复制、先天性巨量计、输尿管-膀胱连接处梗阻、膀胱输尿管反流和后尿道瓣膜。这是由于泌尿系统的异常发育造成的,从出生开始就存在(先天性),尽管异常可能直到晚年才变得明显。CAKUT的临床谱对患者的长期生存有显著影响。我们观察到CAKUT的病因是复杂的,通常是遗传和环境因素共同作用,导致胎儿肾脏和泌尿道发育异常。大多数CAKUT病例的遗传因素尚不清楚;然而,综合征性CAKUT是由与特定综合征相关的基因变化引起的。相同基因的变异也可能是一些孤立的CAKUT病例的基础。本文旨在探讨CAKUT的遗传基础,即识别与综合征型和非综合征型CAKUT相关的不同基因。现代基因检测设备可以提供精确的诊断,可以通过筛查特定的并发症来帮助个性化的临床护理,促进医疗决策,并提供更好的遗传咨询。《中国医学杂志》2022年1月第11期[01:69 . 74
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Genetic Basis of Congenital Anomalies of Kidney and Urinary Tract
Congenital anomalies of kidney and urinary tract (CAKUT) is a group of abnormalities affecting the kidneys or other structures of the urinary tract that include ureters, urinary bladder and urethra. CAKUT include renal agenesis or hypodysplasia, multicystic dysplastic kidney, ureteropelvic junction obstruction, duplication of the pelvis, ureter, and/or kidney, congenital megaureter, ureterovesical junction obstruction, vesicoureteral reflux and posterior urethral valves. Those results from abnormal development of the urinary system and is present from birth (congenital), although the abnormality may not become apparent until later in life. The clinical spectrum of CAKUT has significant impact on long-term patient survival. We observed that the causes of CAKUT are complex, usually combination of genetic and environmental factors contribute to the developmental abnormalities of kidney and urinary tract in foetus. The genetic factors involved in most cases of CAKUT are unknown; however, syndromic CAKUT is caused by changes in the genes associated with the particular syndrome. Variations in the same genes can also underlie some cases of isolated CAKUT. This review paper aims to discuss genetic basis of CAKUT, i.e., identifying different genes involved in syndromic and non-syndromic CAKUT. Modern genetic testing facilities can provide a precise diagnosis that can help individualize clinical care by screening for specific complications, facilitate medical decision making, and provide better genetic counseling. CBMJ 2022 January: vol. 11 no. 01 P: 69-74
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