Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease

Miguel A. Garcia-Gonzalez, Jeffrey G. Jones, Susan K. Allen, Christopher M. Palatucci, Sat D. Batish, William K. Seltzer, Zheng Lan, Erica Allen, Feng Qian, Xose M. Lens, York Pei, Gregory G. Germino, Terry J. Watnick

Research output: Contribution to journalArticle

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is estimated to affect 1/600-1/1000 individuals worldwide. The disease is characterized by age dependent renal cyst formation that results in kidney failure during adulthood. Although ultrasound imaging may be an adequate diagnostic tool in at risk individuals older than 30, this modality may not be sufficiently sensitive in younger individuals or for those from PKD2 families who have milder disease. DNA based assays may be indicated in certain clinical situations where imaging cannot provide a definitive clinical diagnosis. The goal of this study was to evaluate the utility of direct DNA analysis in a test sample of 82 individuals who were judged to have polycystic kidney disease by standard clinical criteria. The samples were analyzed using a commercially available assay that employs sequencing of both genes responsible for the disorder. Definite disease causing mutations were identified in 34 (∼42%) study participants. An additional 30 (∼37%) subjects had either in frame insertions/deletions, non-canonical splice site alterations or a combination of missense changes that were also judged likely to be pathogenic. We noted striking sequence variability in the PKD1 gene, with a mean of 13.1 variants per participant (range 0-60). Our results and analysis highlight the complexity of assessing the pathogenicity of missense variants particularly when individuals have multiple amino acid substitutions. We conclude that a significant fraction of ADPKD mutations are caused by amino acid substitutions that need to be interpreted carefully when utilized in clinical decision-making.

Original languageEnglish (US)
Pages (from-to)160-167
Number of pages8
JournalMolecular Genetics and Metabolism
Volume92
Issue number1-2
DOIs
StatePublished - Sep 2007

Fingerprint

Polycystic Kidney Diseases
Autosomal Dominant Polycystic Kidney
Molecular Biology
Amino Acid Substitution
Mutation
DNA
Systems Analysis
Genes
Renal Insufficiency
Virulence
Cysts
Assays
Ultrasonography
Substitution reactions
Kidney
Imaging techniques
Amino Acids
Ultrasonics
Decision making

Keywords

  • ADPKD
  • Autosomal dominant polycystic kidney disease
  • DNA testing
  • Mutation analysis
  • PKD1
  • PKD2
  • PKDx

ASJC Scopus subject areas

  • Biochemistry
  • Genetics
  • Endocrinology, Diabetes and Metabolism

Cite this

Garcia-Gonzalez, M. A., Jones, J. G., Allen, S. K., Palatucci, C. M., Batish, S. D., Seltzer, W. K., ... Watnick, T. J. (2007). Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease. Molecular Genetics and Metabolism, 92(1-2), 160-167. https://doi.org/10.1016/j.ymgme.2007.05.004

Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease. / Garcia-Gonzalez, Miguel A.; Jones, Jeffrey G.; Allen, Susan K.; Palatucci, Christopher M.; Batish, Sat D.; Seltzer, William K.; Lan, Zheng; Allen, Erica; Qian, Feng; Lens, Xose M.; Pei, York; Germino, Gregory G.; Watnick, Terry J.

In: Molecular Genetics and Metabolism, Vol. 92, No. 1-2, 09.2007, p. 160-167.

Research output: Contribution to journalArticle

Garcia-Gonzalez, MA, Jones, JG, Allen, SK, Palatucci, CM, Batish, SD, Seltzer, WK, Lan, Z, Allen, E, Qian, F, Lens, XM, Pei, Y, Germino, GG & Watnick, TJ 2007, 'Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease', Molecular Genetics and Metabolism, vol. 92, no. 1-2, pp. 160-167. https://doi.org/10.1016/j.ymgme.2007.05.004
Garcia-Gonzalez MA, Jones JG, Allen SK, Palatucci CM, Batish SD, Seltzer WK et al. Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease. Molecular Genetics and Metabolism. 2007 Sep;92(1-2):160-167. https://doi.org/10.1016/j.ymgme.2007.05.004
Garcia-Gonzalez, Miguel A. ; Jones, Jeffrey G. ; Allen, Susan K. ; Palatucci, Christopher M. ; Batish, Sat D. ; Seltzer, William K. ; Lan, Zheng ; Allen, Erica ; Qian, Feng ; Lens, Xose M. ; Pei, York ; Germino, Gregory G. ; Watnick, Terry J. / Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease. In: Molecular Genetics and Metabolism. 2007 ; Vol. 92, No. 1-2. pp. 160-167.
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