Familial autosomal recessive renal tubular acidosis: importance of early diagnosis.
Nephron Physiol
; 119(3): p31-9, 2011.
Article
in En
| MEDLINE
| ID: mdl-21849803
ABSTRACT
BACKGROUND AND AIMS:
Untreated renal tubular acidosis (RTA) can result in severe complications. We reviewed the clinical features of patients with mutations in two genes causing RTA and evaluated their developmental expression assuming that timing, symptom severity and complications may be related to its occurrence.METHODS:
Clinical data from 16 patients with RTA due to mutations in either ATP6V1B1 or CAII were retrospectively reviewed. Both genes' localization and expression pattern in the developing human kidney were analyzed by real-time polymerase chain reaction and immunostaining.RESULTS:
RTA-presenting symptoms were non-specific. Patients with mutations in ATP6V1B1 had earlier presentation (4.9 vs. 11 months, p < 0.041) and longer time to diagnosis than patients with CAII mutations (5.8 vs. 57 months, p < 0.01). Patients with ATP6V1B1 mutations were more likely to develop chronic kidney disease than those with CAII mutations (follow-up GFR values 89 vs. 110 ml/min/1.73 m2, respectively, p < 0.017), probably secondary to nephrocalcinosis. Both ATP6V1B1 and CAII were expressed early during human nephrogenesis, with relatively higher transcript levels of ATP6V1B1.CONCLUSIONS:
There is considerable delay in establishing a diagnosis of both types of RTA, supporting the need for earlier biochemical investigation. RTA due to ATP6V1B1 mutations is associated with mild progressive loss of kidney function.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acidosis, Renal Tubular
/
Vacuolar Proton-Translocating ATPases
/
Carbonic Anhydrase III
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Nephron Physiol
Journal subject:
NEFROLOGIA
Year:
2011
Type:
Article
Affiliation country:
Israel