Abstract

BackgroundAutosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder. It is caused by mutations in the PKD1 and PKD2 genes, and manifests as progressive cyst growth and renal enlargement, resulting in renal failure. Although there have been a few studies on the frequency and spectrum of mutations in PKD1 and PKD2 in Korean patients with ADPKD, only exons 36–46, excluding the duplicated region, were analyzed, which makes it difficult to determine accurate mutation frequencies and mutation spectra.MethodsWe performed sequence analysis of 20 consecutive unrelated ADPKD patients using long-range polymerase chain reaction (PCR) to avoid pseudogene amplification, followed by exon-specific PCR and sequencing of the all exons of these two genes. Multiplex ligation-dependent probe amplification was performed in patients in whom pathogenic mutations in PKD1 or PKD2 were not identified by LR-PCR and direct sequencing to detect large genomic rearrangements.ResultsAll patients met the diagnostic criteria of ADPKD, and pathogenic mutations were found in 18 patients (90.0%), comprising 15 mutations in PKD1 and three in PKD2. Among 10 novel mutations, eight mutations were found in the PKD1 gene while two mutations were found in the PKD2 gene. Eight of 14 PKD1 mutations (57.1%) were located in the duplicated region.ConclusionsThis study expands the spectra of mutations in the PKD1 and PKD2 genes and shows that the mutation frequencies of these genes in Korean ADPKD patients are similar to those reported in other ethnicities. Sequence analysis, including analysis of the duplicated region, is essential for molecular diagnosis of ADPKD.

Highlights

  • Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder

  • During the 4-year study period, we performed mutational analysis using long-range polymerase chain reaction (PCR) (LR-PCR), followed by nested PCR and direct sequencing of PKD1 and PKD2 in 20 unrelated Korean patients diagnosed with ADPKD by ultrasound

  • We identified 20 different variants in PKD1 and PKD2 among 20 ADPKD patients, including 17 pathogenic sequence variants, two variant of unknown significance (VUS) identified by sequence analysis, and one large deletion identified by multiplex ligation-dependent probe amplification (MLPA) analysis

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Summary

Introduction

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder It is caused by mutations in the PKD1 and PKD2 genes, and manifests as progressive cyst growth and renal enlargement, resulting in renal failure. Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder, affecting approximately 1 in 400 to 1,000 individuals in Western countries. It is characterized by progressive cyst growth and renal enlargement, resulting in end stage renal disease (ESRD) [1]. ADPKD is caused by mutations in the PKD1 (16p13.3) and PKD2 (4q21) genes, which produce the proteins polycystin-1 (PC-1) and PC-2, respectively These proteins have critical roles in maintaining normal renal tubular structure during kidney development. Patients with PKD1 mutations exhibit a more progressive renal phenotype than those with PKD2 mutations (average age at onset of ESRD, 53.4 years vs. 72.7 years, respectively) [4]

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