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An international cohort study of autosomal dominant tubulointerstitial kidney disease due to REN mutations identifies distinct clinical subtypes
M. Živná, K. Kidd, M. Zaidan, P. Vyleťal, V. Barešová, K. Hodaňová, J. Sovová, H. Hartmannová, M. Votruba, H. Trešlová, I. Jedličková, J. Sikora, H. Hůlková, V. Robins, A. Hnízda, J. Živný, G. Papagregoriou, L. Mesnard, BB. Beck, A. Wenzel, K....
Language English Country United States
Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.
Grant support
R01 DK119631
NIDDK NIH HHS - United States
R21 DK106584
NIDDK NIH HHS - United States
T32 DK007731
NIDDK NIH HHS - United States
NV17-29786A
MZ0
CEP Register
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- MeSH
- Anemia * MeSH
- Child MeSH
- Adult MeSH
- Cohort Studies MeSH
- Humans MeSH
- Young Adult MeSH
- Mutation MeSH
- Polycystic Kidney Diseases * genetics MeSH
- Renin genetics MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
There have been few clinical or scientific reports of autosomal dominant tubulointerstitial kidney disease due to REN mutations (ADTKD-REN), limiting characterization. To further study this, we formed an international cohort characterizing 111 individuals from 30 families with both clinical and laboratory findings. Sixty-nine individuals had a REN mutation in the signal peptide region (signal group), 27 in the prosegment (prosegment group), and 15 in the mature renin peptide (mature group). Signal group patients were most severely affected, presenting at a mean age of 19.7 years, with the prosegment group presenting at 22.4 years, and the mature group at 37 years. Anemia was present in childhood in 91% in the signal group, 69% prosegment, and none of the mature group. REN signal peptide mutations reduced hydrophobicity of the signal peptide, which is necessary for recognition and translocation across the endoplasmic reticulum, leading to aberrant delivery of preprorenin into the cytoplasm. REN mutations in the prosegment led to deposition of prorenin and renin in the endoplasmic reticulum-Golgi intermediate compartment and decreased prorenin secretion. Mutations in mature renin led to deposition of the mutant prorenin in the endoplasmic reticulum, similar to patients with ADTKD-UMOD, with a rate of progression to end stage kidney disease (63.6 years) that was significantly slower vs. the signal (53.1 years) and prosegment groups (50.8 years) (significant hazard ratio 0.367). Thus, clinical and laboratory studies revealed subtypes of ADTKD-REN that are pathophysiologically, diagnostically, and clinically distinct.
1st Department of Pediatrics Semmelweis University Budapest Hungary
AP HP CIC BT 504 Créteil France
AP HP Groupe Hospitalier Henri Mondor Albert Chenevier Créteil France
Centre Hospitalier Universitaire de Toulouse Toulouse France
Département Biologie cellulaire INSERM U1151 Institut Necker Enfants Malades Paris France
Department of Biochemistry University of Cambridge Cambridge UK
Department of Nephrology and Renal Transplantation University Hospitals Leuven Leuven Belgium
Department of Nephrology Evangelismos Private Hospital Pafos Cyprus
Department of Nephrology‒Transplantation Necker Hospital APHP Paris France
Department of Pediatric Nephrology Medical University Wrocław Poland
Division of Nephrology Department of Pediatrics University of Florida Gainesville Florida USA
Division of Nephrology Indiana University School of Medicine Indianapolis Indiana USA
Division of Nephrology Ospedale Sant'Orsola‒Malpighi Bologna Italy
Duke Clinical Research Institute Durham North Carolina USA
Exeter Kidney Unit Royal Devon and Exeter NHS Foundation Trust Exeter Devon UK
France Rare Renal Disease Reference Centre Toulouse France
Institute of Pathophysiology 1st Faculty of Medicine Charles University Prague Czech Republic
Laboratory of Human Molecular Genetics Faculty of Medicine University of Sfax Sfax Tunisia
Medical Genetics Department of Hedi Chaker Hospital Sfax Tunisia
Medical Genetics Unit Policlinico S Orsola Malpighi Bologna Italy
MTA SE Lendület Nephrogenetic Laboratory Semmelweis University Budapest Hungary
Nephrology Division University of Montreal Hospital Centre Hopital Saint Luc Montréal Québec Canada
NIHR Newcastle Biomedical Research Centre Newcastle University Newcastle upon Tyne UK
Paris Descartes University Sorbonne Paris Cité Paris France
Pediatric Nephrology Centre Hospitalier Universitaire de Toulouse Toulouse France
Pediatric Nephrology University of Texas Southwestern Medical Center Dallas Texas USA
Pediatrics Nephrology Marshfield Medical Center Marshfield Wisconsin USA
Renal Services The Newcastle Hospitals NHS Foundation Trust Newcastle upon Tyne UK
Section on Nephrology Wake Forest School of Medicine Winston Salem North Carolina USA
Service de Néphrologie‒Transplantation Hôpital de Bicêtre Le Kremlin Bicêtre France
Université Paris Est Créteil Equipe 21 INSERM U 955 Créteil France
References provided by Crossref.org
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- $a Živná, Martina $u Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
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- $a An international cohort study of autosomal dominant tubulointerstitial kidney disease due to REN mutations identifies distinct clinical subtypes / $c M. Živná, K. Kidd, M. Zaidan, P. Vyleťal, V. Barešová, K. Hodaňová, J. Sovová, H. Hartmannová, M. Votruba, H. Trešlová, I. Jedličková, J. Sikora, H. Hůlková, V. Robins, A. Hnízda, J. Živný, G. Papagregoriou, L. Mesnard, BB. Beck, A. Wenzel, K. Tory, K. Häeffner, MTF. Wolf, ME. Bleyer, JA. Sayer, ACM. Ong, L. Balogh, A. Jakubowska, A. Łaszkiewicz, R. Clissold, C. Shaw-Smith, R. Munshi, RM. Haws, C. Izzi, I. Capelli, M. Santostefano, C. Graziano, F. Scolari, A. Sussman, H. Trachtman, S. Decramer, M. Matignon, P. Grimbert, LR. Shoemaker, C. Stavrou, M. Abdelwahed, N. Belghith, M. Sinclair, K. Claes, T. Kopel, S. Moe, C. Deltas, B. Knebelmann, L. Rampoldi, S. Kmoch, AJ. Bleyer
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- $a There have been few clinical or scientific reports of autosomal dominant tubulointerstitial kidney disease due to REN mutations (ADTKD-REN), limiting characterization. To further study this, we formed an international cohort characterizing 111 individuals from 30 families with both clinical and laboratory findings. Sixty-nine individuals had a REN mutation in the signal peptide region (signal group), 27 in the prosegment (prosegment group), and 15 in the mature renin peptide (mature group). Signal group patients were most severely affected, presenting at a mean age of 19.7 years, with the prosegment group presenting at 22.4 years, and the mature group at 37 years. Anemia was present in childhood in 91% in the signal group, 69% prosegment, and none of the mature group. REN signal peptide mutations reduced hydrophobicity of the signal peptide, which is necessary for recognition and translocation across the endoplasmic reticulum, leading to aberrant delivery of preprorenin into the cytoplasm. REN mutations in the prosegment led to deposition of prorenin and renin in the endoplasmic reticulum-Golgi intermediate compartment and decreased prorenin secretion. Mutations in mature renin led to deposition of the mutant prorenin in the endoplasmic reticulum, similar to patients with ADTKD-UMOD, with a rate of progression to end stage kidney disease (63.6 years) that was significantly slower vs. the signal (53.1 years) and prosegment groups (50.8 years) (significant hazard ratio 0.367). Thus, clinical and laboratory studies revealed subtypes of ADTKD-REN that are pathophysiologically, diagnostically, and clinically distinct.
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