Whole-exome resequencing distinguishes cystic kidney diseases from phenocopies in renal ciliopathies.

Journal Article

Rare single-gene disorders cause chronic disease. However, half of the 6000 recessive single gene causes of disease are still unknown. Because recessive disease genes can illuminate, at least in part, disease pathomechanism, their identification offers direct opportunities for improved clinical management and potentially treatment. Rare diseases comprise the majority of chronic kidney disease (CKD) in children but are notoriously difficult to diagnose. Whole-exome resequencing facilitates identification of recessive disease genes. However, its utility is impeded by the large number of genetic variants detected. We here overcome this limitation by combining homozygosity mapping with whole-exome resequencing in 10 sib pairs with a nephronophthisis-related ciliopathy, which represents the most frequent genetic cause of CKD in the first three decades of life. In 7 of 10 sibships with a histologic or ultrasonographic diagnosis of nephronophthisis-related ciliopathy, we detect the causative gene. In six sibships, we identify mutations of known nephronophthisis-related ciliopathy genes, while in two additional sibships we found mutations in the known CKD-causing genes SLC4A1 and AGXT as phenocopies of nephronophthisis-related ciliopathy. Thus, whole-exome resequencing establishes an efficient, noninvasive approach towards early detection and causation-based diagnosis of rare kidney diseases. This approach can be extended to other rare recessive disorders, thereby providing accurate diagnosis and facilitating the study of disease mechanisms.

Full Text

Duke Authors

Cited Authors

  • Gee, HY; Otto, EA; Hurd, TW; Ashraf, S; Chaki, M; Cluckey, A; Vega-Warner, V; Saisawat, P; Diaz, KA; Fang, H; Kohl, S; Allen, SJ; Airik, R; Zhou, W; Ramaswami, G; Janssen, S; Fu, C; Innis, JL; Weber, S; Vester, U; Davis, EE; Katsanis, N; Fathy, HM; Jeck, N; Klaus, G; Nayir, A; Rahim, KA; Al Attrach, I; Al Hassoun, I; Ozturk, S; Drozdz, D; Helmchen, U; O'Toole, JF; Attanasio, M; Lewis, RA; Nürnberg, G; Nürnberg, P; Washburn, J; MacDonald, J; Innis, JW; Levy, S; Hildebrandt, F

Published Date

  • April 2014

Published In

Volume / Issue

  • 85 / 4

Start / End Page

  • 880 - 887

PubMed ID

  • 24257694

Electronic International Standard Serial Number (EISSN)

  • 1523-1755

Digital Object Identifier (DOI)

  • 10.1038/ki.2013.450

Language

  • eng

Conference Location

  • United States