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Genomic profiling in (recurrent) steroid-resistant nephrotic syndrome

Subject Area Nephrology
Human Genetics
Term from 2019 to 2022
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 418039699
 
Final Report Year 2023

Final Report Abstract

Identification of the genetic basis of isolated or complex kidney diseases (diseases that not only affect the kidneys but also other organ systems) is already possible today for a substantial proportion of pediatric patients but for a relevant proportion of adult patients. New DNA sequencing methods such as the so-called long-read sequencing methods, which allow reading lengths of several tens of thousands of DNA bases in one piece, allow for a far better detection of structural DNA changes relevant to disease and thus further increase the rate of detectable genetic diseases. A definite molecular diagnosis can already contribute to better (symptomatic) treatment of kidney disease and is sometimes even capable of preventing the need for dialysis therapy for life. In addition, the identification of family members at risk and, if necessary, timely treatment of other family members using genetics is quick and efficient. This is particularly important in pediatric setting in of early-onset severe kidney dysfunction with the option of living donation by a parent, but also in many constellations in the field of adult nephrology. Not only can genomic methods be used to diagnose diseases, the release of cell-free DNA (cfDNA) into the bloodstream (and other body fluids such as urine) also allows the use of DNA as a biomarker for kidney diseases. In the future, patients who show a specific pattern of cell-free DNA released from their kidney tissue in the bloodstream that associates with a high risk of acute kidney injury could be continuously monitored and preemptively treated through a simple blood sample based cfDNA assay. Genetic finding that clarify the causes of mostly rare genetic kidney disease (rare) genetic kidney diseases will not only allow for targeted treatment of these diseases in the future, but can also be transferred to other, more common forms of chronic kidney diseases and can thus benefit a significantly larger group of patients.

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