Translational strategies to uncover the etiology of congenital anomalies of the kidney and urinary tract

While up to 50% of children requiring kidney replacement therapy have congenital anomalies of the kidney and urinary tract (CAKUT), they represent only a fraction of the total patient population with CAKUT. The extreme variability in clinical outcome underlines the fundamental need to devise persona...

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Published in:Pediatric nephrology (Berlin, West) West), 2024-10, Vol.40 (3), p.685-699
Main Authors: Vendrig, Lisanne M., ten Hoor, Mayke A. C., König, Benthe H., Lekkerkerker, Iris, Renkema, Kirsten Y., Schreuder, Michiel F., van der Zanden, Loes F. M., van Eerde, Albertien M., Groen in ’t Woud, Sander, Mulder, Jaap, Westland, Rik
Format: Article
Language:English
Subjects:
Biomarkers
Birth defects
Clinical outcomes
Congenital defects
Educational Review
Environmental factors
Kidneys
Medicine
Medicine & Public Health
Nephrology
Patients
Pediatrics
Translation
Urinary tract
Urogenital system
Urology
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Summary:While up to 50% of children requiring kidney replacement therapy have congenital anomalies of the kidney and urinary tract (CAKUT), they represent only a fraction of the total patient population with CAKUT. The extreme variability in clinical outcome underlines the fundamental need to devise personalized clinical management strategies for individuals with CAKUT. Better understanding of the pathophysiology of abnormal kidney and urinary tract development provides a framework for precise diagnoses and prognostication of patients, the identification of biomarkers and disease modifiers, and, thus, the development of personalized strategies for treatment. In this review, we provide a state-of-the-art overview of the currently known genetic causes, including rare variants in kidney and urinary tract development genes, genomic disorders, and common variants that have been attributed to CAKUT. Furthermore, we discuss the impact of environmental factors and their interactions with developmental genes in kidney and urinary tract malformations. Finally, we present multi-angle translational modalities to validate candidate genes and environmental factors and shed light on future strategies to better understand the molecular underpinnings of CAKUT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information
ISSN:0931-041X
1432-198X
1432-198X
DOI:10.1007/s00467-024-06479-2