Evaluation of phenotypic and genotypic features of children with distal kidney tubular acidosis
- PDF / 531,270 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 32 Downloads / 240 Views
ORIGINAL ARTICLE
Evaluation of phenotypic and genotypic features of children with distal kidney tubular acidosis Bahriye Atmis 1 & Derya Cevizli 1 & Engin Melek 1 & Atil Bisgin 2,3 & Ilker Unal 4 & Ali Anarat 1 & Aysun K. Bayazit 1 Received: 14 April 2020 / Revised: 16 June 2020 / Accepted: 18 June 2020 # IPNA 2020
Abstract Background The present study aimed to assess genotype–phenotype correlations with long-term prognosis in children with distal kidney tubular acidosis (dKTA). The kidney function of children with dKTA could be impaired in the long-term. Methods Thirty-one children with dKTA from 23 families were included in the present study. Demographic features, growth parameters, clinical manifestations, follow-up results, and genetic analysis results of the patients were recorded. Results Eighteen children (58.1%) were male. The median age at diagnosis was 3 months. The median follow-up period was 77 months and the longest was 23.5 years. Eight (28.8%) patients had chronic kidney disease (CKD) stage 2 or 3. Three patients aged 24, 23, and 19 years had CKD stage 3 with an estimated glomerular filtration rate of 54, 57, and 48 mL/min/1.73 m2, respectively. Thirteen patients had mutations in the ATP6V0A4 gene, eight had mutations in the ATP6V1B1 gene, and three had mutations in the SLC4A1 gene. There was no significant correlation between molecular diagnosis and CKD. Growth retardation with a height below a standard deviation (SD) score of − 2 was found in 14 patients (45.1%) at the time of diagnosis. The mean height SD score at the last visit was significantly higher in patients who had adequate metabolic control at > 75% of all visits as compared with that in patients who did not. Conclusion Patients with dKTA usually have a good clinical prognosis in childhood with appropriate treatment; however, dRTA is characterized by deterioration of kidney function in adulthood, particularly after puberty. Keywords Children . Distal kidney tubular acidosis . Genetic analysis . Long-term prognosis
Introduction Distal kidney tubular acidosis (dKTA) is a tubular disorder characterized by hyperchloremic (normal anion gap) metabolic acidosis, alkaline urine, hypokalemia, hypercalciuria, and nephrocalcinosis [1]. In dRTA, ɑ-intercalated cells in the
* Bahriye Atmis [email protected] 1
Department of Pediatric Nephrology, Cukurova University Faculty of Medicine, Adana, Turkey
2
Department of Medical Genetics, Faculty of Medicine, Cukurova University, Adana, Turkey
3
Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
4
Department of Biostatistics, Cukurova University Faculty of Medicine, Adana, Turkey
collecting duct are unable to secrete H+ ions and acidify urine or reabsorb HCO3− [2, 3]. dKTA can be caused by mutations in three genes: ATP6V1B1, ATP6V0A4, and SLC4A1 [4]. ATP6V1B1 and ATP6V0A4 encode subunits of the vacuolar H+-ATPase, which has autosomal recessive inheritance, and SLC4A1 encodes anion exchanger 1, which has autosomal dominant inheritance [5–7]. Rec
Data Loading...
