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Details

Autor(en) / Beteiligte
Titel
Clinical and Genetic Spectrum of Bartter Syndrome Type 3
Ist Teil von
  • Journal of the American Society of Nephrology, 2017-08, Vol.28 (8), p.2540-2552
Ort / Verlag
United States: American Society of Nephrology
Erscheinungsjahr
2017
Link zum Volltext
Quelle
Electronic Journals Library
Beschreibungen/Notizen
  • Bartter syndrome type 3 is a clinically heterogeneous hereditary salt-losing tubulopathy caused by mutations of the chloride voltage-gated channel Kb gene ( ), which encodes the ClC-Kb chloride channel involved in NaCl reabsorption in the renal tubule. To study phenotype/genotype correlations, we performed genetic analyses by direct sequencing and multiplex ligation-dependent probe amplification and retrospectively analyzed medical charts for 115 patients with mutations. Functional analyses were performed in oocytes for eight missense and two nonsense mutations. We detected 60 mutations, including 27 previously unreported mutations. Among patients, 29.5% had a phenotype of ante/neonatal Bartter syndrome (polyhydramnios or diagnosis in the first month of life), 44.5% had classic Bartter syndrome (diagnosis during childhood, hypercalciuria, and/or polyuria), and 26.0% had Gitelman-like syndrome (fortuitous discovery of hypokalemia with hypomagnesemia and/or hypocalciuria in childhood or adulthood). Nine of the ten mutations expressed decreased or abolished chloride conductance. Severe (large deletions, frameshift, nonsense, and essential splicing) and missense mutations resulting in poor residual conductance were associated with younger age at diagnosis. Electrolyte supplements and indomethacin were used frequently to induce catch-up growth, with few adverse effects. After a median follow-up of 8 (range, 1-41) years in 77 patients, chronic renal failure was detected in 19 patients (25%): one required hemodialysis and four underwent renal transplant. In summary, we report a genotype/phenotype correlation for Bartter syndrome type 3: complete loss-of-function mutations associated with younger age at diagnosis, and CKD was observed in all phenotypes.
Sprache
Englisch
Identifikatoren
ISSN: 1046-6673
eISSN: 1533-3450
DOI: 10.1681/asn.2016101057
Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5533235

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