Skip to main content
Top
Published in: Pediatric Nephrology 4/2012

01-04-2012 | Brief Report

Evidence that NPHS2-R229Q predisposes to proteinuria and renal failure in familial hematuria

Authors: Konstantinos Voskarides, Maria Arsali, Yiannis Athanasiou, Avraam Elia, Alkis Pierides, Constantinos Deltas

Published in: Pediatric Nephrology | Issue 4/2012

Login to get access

Abstract

Background

Familial hematuria (FH) is associated with at least two pathological entities: thin basement membrane nephropathy (TBMN), caused by heterozygous COL4A3/COL4A4 mutations, and C3 nephropathy caused by CFHR5 mutations. It is now known that TBMN patients develop proteinuria and changes of focal segmental glomerulosclerosis when biopsied. End-stage kidney disease (ESKD) is observed in 20% of carriers, at ages 50–70. A similar progression is observed in CFHR5 nephropathy. Recent evidence suggests that NPHS2-R229Q, a podocin polymorphism, may contribute to proteinuria in TBMN and to micro-albuminuria in the general population.

Case-Diagnosis/Treatment

NPHS2-R229Q was screened in a Cypriot FH cohort. 102 TBMN patients with three known COL4 mutations and 45 CFHR5 male patients with a single mutation were categorized as “Mild” or “Severe”, based on the presence of microhematuria only, or proteinuria and chronic kidney disease. Nine R229Q carriers were found in the “Severe” category and none in the “Mild” (p=0.010 for genotypic association; p=0.043 for allelic association, adjusted for patients’ relatedness), thus supporting the possible contribution of 229Q allele in disease progress.

Conclusions

Our results offer more evidence that in patients with FH, NPHS2-R229Q predisposes to proteinuria and ESKD. R229Q may be a good prognostic marker for young hematuric patients.
Literature
1.
go back to reference Kashtan CE (2005) Familial hematurias: what we know and what we don’t. Pediatr Nephrol 20:1027–1035PubMedCrossRef Kashtan CE (2005) Familial hematurias: what we know and what we don’t. Pediatr Nephrol 20:1027–1035PubMedCrossRef
2.
go back to reference Gale DP, de Jorge EG, Cook HT, Martinez-Barricarte R, Hadjisavvas A, Adam G, McLean AG, Pusey CD, Pierides A, Kyriacou K, Athanasiou Y, Voskarides C, Deltas C, Palmer A, Frémeaux-Bacchi V, Cordoba SR, Maxwell PH, Pickering MC (2010) Identification of a mutation in complement factor H-related protein 5 in patients of Cypriot origin with glomerulonephritis. Lancet 376:794–801PubMedCrossRef Gale DP, de Jorge EG, Cook HT, Martinez-Barricarte R, Hadjisavvas A, Adam G, McLean AG, Pusey CD, Pierides A, Kyriacou K, Athanasiou Y, Voskarides C, Deltas C, Palmer A, Frémeaux-Bacchi V, Cordoba SR, Maxwell PH, Pickering MC (2010) Identification of a mutation in complement factor H-related protein 5 in patients of Cypriot origin with glomerulonephritis. Lancet 376:794–801PubMedCrossRef
3.
go back to reference Athanasiou Y, Voskarides K, Gale D, Damianou L, Patsias C, Zavros M, Maxwell P, Cook T, Demosthenous P, Hatjisavvas A, Kyriacou K, Zouvani I, Pierides M, Deltas C (2011) Familial C3 glomerulopathy associated with CFHR5 mutations: Clinical characteristics of 91 patients in 16 pedigrees. Clin J Am Soc Nephrol 6:1436–1446PubMedCrossRef Athanasiou Y, Voskarides K, Gale D, Damianou L, Patsias C, Zavros M, Maxwell P, Cook T, Demosthenous P, Hatjisavvas A, Kyriacou K, Zouvani I, Pierides M, Deltas C (2011) Familial C3 glomerulopathy associated with CFHR5 mutations: Clinical characteristics of 91 patients in 16 pedigrees. Clin J Am Soc Nephrol 6:1436–1446PubMedCrossRef
4.
go back to reference Voskarides K, Damianou L, Neocleous V, Zouvani I, Christodoulidou S, Hadjiconstantinou V, Ioannou K, Athanasiou Y, Patsias C, Alexopoulos E, Pierides A, Kyriacou K, Deltas C (2007) COL4A3/COL4A4 mutations producing focal segmental glomerulosclerosis and renal failure in thin basement membrane nephropathy. J Am Soc Nephrol 18:3004–3016PubMedCrossRef Voskarides K, Damianou L, Neocleous V, Zouvani I, Christodoulidou S, Hadjiconstantinou V, Ioannou K, Athanasiou Y, Patsias C, Alexopoulos E, Pierides A, Kyriacou K, Deltas C (2007) COL4A3/COL4A4 mutations producing focal segmental glomerulosclerosis and renal failure in thin basement membrane nephropathy. J Am Soc Nephrol 18:3004–3016PubMedCrossRef
5.
go back to reference Pierides A, Voskarides K, Athanasiou Y, Ioannou K, Damianou L, Arsali M, Zavros M, Pierides M, Vargemezis V, Patsias C, Zouvani I, Kyriacou K, Deltas (2009) Clinico-pathological correlations in 127 patients in 11 large pedigrees, segregating one of three heterozygous mutations in the COL4A3/COL4A4 genes associated with familial haematuria and significant late progression to proteinuria and chronic kidney disease from focal segmental glomerulosclerosis. Nephrol Dial Transplant 24:2721–2729PubMedCrossRef Pierides A, Voskarides K, Athanasiou Y, Ioannou K, Damianou L, Arsali M, Zavros M, Pierides M, Vargemezis V, Patsias C, Zouvani I, Kyriacou K, Deltas (2009) Clinico-pathological correlations in 127 patients in 11 large pedigrees, segregating one of three heterozygous mutations in the COL4A3/COL4A4 genes associated with familial haematuria and significant late progression to proteinuria and chronic kidney disease from focal segmental glomerulosclerosis. Nephrol Dial Transplant 24:2721–2729PubMedCrossRef
7.
go back to reference Tonna S, Wang YY, Wilson D, Rigby L, Tabone T, Cotton R, Savige J (2008) The R229Q mutation in NPHS2 may predispose to proteinuria in thin-basement-membrane nephropathy. Pediatr Nephrol 23:2201–2207PubMedCrossRef Tonna S, Wang YY, Wilson D, Rigby L, Tabone T, Cotton R, Savige J (2008) The R229Q mutation in NPHS2 may predispose to proteinuria in thin-basement-membrane nephropathy. Pediatr Nephrol 23:2201–2207PubMedCrossRef
8.
go back to reference Pereira AC, Pereira AB, Mota GF, Cunha RS, Herkenhoff FL, Pollak MR, Mill JG, Krieger JE (2004) NPHS2 R229Q functional variant is associated with microalbuminuria in the general population. Kidney Int 65:1026–1030PubMedCrossRef Pereira AC, Pereira AB, Mota GF, Cunha RS, Herkenhoff FL, Pollak MR, Mill JG, Krieger JE (2004) NPHS2 R229Q functional variant is associated with microalbuminuria in the general population. Kidney Int 65:1026–1030PubMedCrossRef
9.
go back to reference Bourgain C, Hoffjan S, Nicolae R, Newman D, Steiner L, Walker K, Reynolds R, Ober C, McPeek MS (2003) Novel Case-Control Test in a Founder Population Identifies P-Selectinas an Atopy-Susceptibility Locus. Am J Hum Genet 73:612–626PubMedCrossRef Bourgain C, Hoffjan S, Nicolae R, Newman D, Steiner L, Walker K, Reynolds R, Ober C, McPeek MS (2003) Novel Case-Control Test in a Founder Population Identifies P-Selectinas an Atopy-Susceptibility Locus. Am J Hum Genet 73:612–626PubMedCrossRef
10.
go back to reference Tsukaguchi H, Sudhakar A, Le TC, Nguyen T, Yao J, Schwimmer JA, Schachter AD, Poch E, Abreu PF, Appel GB, Pereira AB, Kalluri R, Pollak MR (2002) NPHS2 mutations in late-onset focal segmental glomerulosclerosis: R229Q is a common disease-associated allele. J Clin Invest 110:1659–1666PubMed Tsukaguchi H, Sudhakar A, Le TC, Nguyen T, Yao J, Schwimmer JA, Schachter AD, Poch E, Abreu PF, Appel GB, Pereira AB, Kalluri R, Pollak MR (2002) NPHS2 mutations in late-onset focal segmental glomerulosclerosis: R229Q is a common disease-associated allele. J Clin Invest 110:1659–1666PubMed
11.
go back to reference Machuca E, Hummel A, Nevo F, Dantal J, Martinez F, Al-Sabban E, Baudouin V, Abel L, Grünfeld JP, Antignac C (2009) Clinical and epidemiological assessment of steroid-resistant nephrotic syndrome associated with the NPHS2 R229Q variant. Kidney Int 75:727–735PubMedCrossRef Machuca E, Hummel A, Nevo F, Dantal J, Martinez F, Al-Sabban E, Baudouin V, Abel L, Grünfeld JP, Antignac C (2009) Clinical and epidemiological assessment of steroid-resistant nephrotic syndrome associated with the NPHS2 R229Q variant. Kidney Int 75:727–735PubMedCrossRef
12.
go back to reference Caridi G, Gigante M, Ravani P, Trivelli A, Barbano G, Scolari F, Dagnino M, Murer L, Murtas C, Edefonti A, Allegri L, Amore A, Coppo R, Emma F, De Palo T, Penza R, Gesualdo L, Ghiggeri GM (2009) Clinical features and long-term outcome of nephrotic syndrome associated with heterozygous NPHS1 and NPHS2 mutations. Clin J Am Soc Nephrol 4:1065–1072PubMedCrossRef Caridi G, Gigante M, Ravani P, Trivelli A, Barbano G, Scolari F, Dagnino M, Murer L, Murtas C, Edefonti A, Allegri L, Amore A, Coppo R, Emma F, De Palo T, Penza R, Gesualdo L, Ghiggeri GM (2009) Clinical features and long-term outcome of nephrotic syndrome associated with heterozygous NPHS1 and NPHS2 mutations. Clin J Am Soc Nephrol 4:1065–1072PubMedCrossRef
13.
go back to reference Santín S, Tazón-Vega B, Silva I, Cobo MÁ, Giménez I, Ruíz P, García-Maset R, Ballarín J, Torra R, Ars E; FSGS Spanish Study Group (2011) Clinical value of NPHS2 analysis in early- and adult-onset steroid-resistant nephrotic syndrome. Clin J Am Soc Nephrol 6:344–354PubMedCrossRef Santín S, Tazón-Vega B, Silva I, Cobo MÁ, Giménez I, Ruíz P, García-Maset R, Ballarín J, Torra R, Ars E; FSGS Spanish Study Group (2011) Clinical value of NPHS2 analysis in early- and adult-onset steroid-resistant nephrotic syndrome. Clin J Am Soc Nephrol 6:344–354PubMedCrossRef
14.
go back to reference Köttgen A, Hsu CC, Coresh J, Shuldiner AR, Berthier-Schaad Y, Gambhir TR, Smith MW, Boerwinkle E, Kao WHL (2008) The Association of Podocin R229Q Polymorphism With Increased Albuminuria or Reduced Estimated GFR in a Large Population-Based Sample of US Adults. Am J Kidney Dis 52:868–875PubMedCrossRef Köttgen A, Hsu CC, Coresh J, Shuldiner AR, Berthier-Schaad Y, Gambhir TR, Smith MW, Boerwinkle E, Kao WHL (2008) The Association of Podocin R229Q Polymorphism With Increased Albuminuria or Reduced Estimated GFR in a Large Population-Based Sample of US Adults. Am J Kidney Dis 52:868–875PubMedCrossRef
15.
go back to reference Franceschini N, North KE, Kopp JB, McKenzie L, Winkler C (2006) NPHS2 gene, nephrotic syndrome and focal segmental glomerulosclerosis: a HuGE review. Genet Med 8:63–75PubMedCrossRef Franceschini N, North KE, Kopp JB, McKenzie L, Winkler C (2006) NPHS2 gene, nephrotic syndrome and focal segmental glomerulosclerosis: a HuGE review. Genet Med 8:63–75PubMedCrossRef
Metadata
Title
Evidence that NPHS2-R229Q predisposes to proteinuria and renal failure in familial hematuria
Authors
Konstantinos Voskarides
Maria Arsali
Yiannis Athanasiou
Avraam Elia
Alkis Pierides
Constantinos Deltas
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Pediatric Nephrology / Issue 4/2012
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-011-2084-6

Other articles of this Issue 4/2012

Pediatric Nephrology 4/2012 Go to the issue