30 research outputs found

    Clinical and Functional Characterization of URAT1 Variants

    Get PDF
    Idiopathic renal hypouricaemia is an inherited form of hypouricaemia, associated with abnormal renal handling of uric acid. There is excessive urinary wasting of uric acid resulting in hypouricaemia. Patients may be asymptomatic, but the persistent urinary abnormalities may manifest as renal stone disease, and hypouricaemia may manifest as exercise induced acute kidney injury. Here we have identified Macedonian and British patients with hypouricaemia, who presented with a variety of renal symptoms and signs including renal stone disease, hematuria, pyelonephritis and nephrocalcinosis. We have identified heterozygous missense mutations in SLC22A12 encoding the urate transporter protein URAT1 and correlate these genetic findings with functional characterization. Urate handling was determined using uptake experiments in HEK293 cells. This data highlights the importance of the URAT1 renal urate transporter in determining serum urate concentrations and the clinical phenotypes, including nephrolithiasis, that should prompt the clinician to suspect an inherited form of renal hypouricaemia

    Genetic Drivers of Kidney Defects in the DiGeorge Syndrome

    Get PDF
    Background The DiGeorge syndrome, the most common of the microdeletion syndromes, affects multiple organs, including the heart, the nervous system, and the kidney. It is caused by deletions on chromosome 22q11.2; the genetic driver of the kidney defects is unknown. Methods We conducted a genomewide search for structural variants in two cohorts: 2080 patients with congenital kidney and urinary tract anomalies and 22,094 controls. We performed exome and targeted resequencing in samples obtained from 586 additional patients with congenital kidney anomalies. We also carried out functional studies using zebrafish and mice. Results We identified heterozygous deletions of 22q11.2 in 1.1% of the patients with congenital kidney anomalies and in 0.01% of population controls (odds ratio, 81.5; P=4.5×10(-14)). We localized the main drivers of renal disease in the DiGeorge syndrome to a 370-kb region containing nine genes. In zebrafish embryos, an induced loss of function in snap29, aifm3, and crkl resulted in renal defects; the loss of crkl alone was sufficient to induce defects. Five of 586 patients with congenital urinary anomalies had newly identified, heterozygous protein-altering variants, including a premature termination codon, in CRKL. The inactivation of Crkl in the mouse model induced developmental defects similar to those observed in patients with congenital urinary anomalies. Conclusions We identified a recurrent 370-kb deletion at the 22q11.2 locus as a driver of kidney defects in the DiGeorge syndrome and in sporadic congenital kidney and urinary tract anomalies. Of the nine genes at this locus, SNAP29, AIFM3, and CRKL appear to be critical to the phenotype, with haploinsufficiency of CRKL emerging as the main genetic driver. (Funded by the National Institutes of Health and others.)

    Perioperative parameters included in the analysis.

    No full text
    <p><sup>*</sup>total volume collected during surgery including ascites, rinsing fluids, and blood.</p

    Patient Allocation.

    No full text
    <p>Of 429 patients who underwent liver transplantation at our institution from December 2006 till March 2011, 266 were eligible for inclusion in the study. <sup>*</sup>incl. 18 HU-listed, 33 split/living related, and 5 retransplantations; excl. <sup>**</sup><18 years; <sup>***</sup><18 years or HU-listed; <sup>****</sup><18 years, HU-listed or split/living related or combined organ transplantation.</p

    Multivariate, logistic regression analysis of patient survival rates.

    No full text
    <p>Final model of the multivariate logistic regression analysis of clinical parameters associated with the 90-day timeframe for patient survival in the study population. Clinical parameters included in the multivariate analysis were significant at the 10% level in the univariate analysis. OR: odds ratio; CI: confidence interval; DRI: donor risk index.</p
    corecore