Clinical Genetic Screening in Adult Patients with Kidney Disease

Clin J Am Soc Nephrol. 2020 Oct 7;15(10):1497-1510. doi: 10.2215/CJN.15141219. Epub 2020 Jul 9.

Abstract

Expanded accessibility of genetic sequencing technologies, such as chromosomal microarray and massively parallel sequencing approaches, is changing the management of hereditary kidney diseases. Genetic causes account for a substantial proportion of pediatric kidney disease cases, and with increased utilization of diagnostic genetic testing in nephrology, they are now also detected at appreciable frequencies in adult populations. Establishing a molecular diagnosis can have many potential benefits for patient care, such as guiding treatment, familial testing, and providing deeper insights on the molecular pathogenesis of kidney diseases. Today, with wider clinical use of genetic testing as part of the diagnostic evaluation, nephrologists have the challenging task of selecting the most suitable genetic test for each patient, and then applying the results into the appropriate clinical contexts. This review is intended to familiarize nephrologists with the various technical, logistical, and ethical considerations accompanying the increasing utilization of genetic testing in nephrology care.

Keywords: CGH array; Chronic; Genetic Testing; High-Throughput Nucleotide Sequencing; Kidney Genomics Series; Patient Care; Renal Insufficiency; Sanger sequencing; array techniques; chronic kidney disease; familial kidney disease; familial nephropathy; genetic renal disease; genetics; genomics; human genetic testing; human genetics; kidney disease; massive parallel sequencing; medical genetics; microarray techniques; nephrology; referral and consultation; translations; whole exome sequencing; whole genome sequencing.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Clinical Trials as Topic
  • Comparative Genomic Hybridization
  • Exome
  • Genetic Testing* / ethics
  • Genetic Testing* / methods
  • Genome
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / genetics*
  • Kidney Diseases / therapy
  • Mutation
  • Oligonucleotide Array Sequence Analysis
  • Polymorphism, Genetic
  • Sequence Analysis, DNA*