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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease that results in multiple cysts in the kidneys and other organs and leads to endstage renal failure relatively late in life. The disease results from mutations in one of two independently segregating genes that under normal conditions produce polycystines. Polycystines are membrane proteins that form a complex involved in signal transduction in epithelial cells. Genetic heterogeneity explains in part the various ADPKD phenotypes.
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PMID:[From gene to disease; from polycystines to polycystic kidney disease]. 1153 Jul 11

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited nephropathy, usually of late onset (onset between third to seventh decade), primarily characterized by the formation of fluid-filled cysts in the kidneys. It is one of the most frequent inherited conditions affecting approximately 1:1,000 Caucasians. Two major genes have been identified and characterized in detail: PKD1 and PKD2, mapping on chromosomes 16p13.3 and 4q21-23, respectively. A third gene, PKD3, has been implicated in selected families. Polycystic kidney disease of types 1 or 2 follows a very similar course of symptoms, both being multisystem pleiotropic disorders of indistinguishable picture on clinical grounds. The only difference is that patients with PKD2 mutations run a milder course compared to PKD1 carriers, with an average 10-20 years later age of onset and lower probability to reach end-stage-renal failure. The proteins polycystin-1 and -2 are trans-membranous glycoproteins hypothesized to participate in a common signaling pathway, interacting with each other and with other proteins, and coordinately expressed in normal and cystic tissue. Renal cysts most probably arise after a second somatic event, which inactivates the inherited healthy allele of the same gene, or perhaps one of the alleles of the other gene counterpart, generating a trans-heterozygous state. This article reviews the reported mutations in PKD2. Mutations of all kinds have been reported over the entire sequence of the PKD2 gene, with no apparent significant clustering and with some evidence of genotype/phenotype correlation. Most families harbor their own private mutations but a few recurrent events have been reported in unrelated families.
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PMID:Mutations of the human polycystic kidney disease 2 (PKD2) gene. 1143 89

Autosomal dominant polycystic kidney disease (ADPKD) strikes 1 in 1000 individuals and often results in end-stage renal failure. Mutations in either PKD1 or PKD2 account for 95% of all cases [1-3]. It has recently been demonstrated that polycystin-1 and polycystin-2 (encoded by PKD1 and PKD2, respectively) assemble to form a cation channel in vitro [4]. Here we determine that the Caenorhabditis elegans PKD1 and PKD2 homologs, lov-1 [5] and pkd-2, act in the same pathway in vivo. Mutations in either lov-1 or pkd-2 result in identical male sensory behavioral defects. Also, pkd-2;lov-1 double mutants are no more severe than either of the single mutants, indicating that lov-1 and pkd-2 act together. LOV-1::GFP and PKD-2::GFP are expressed in the same male-specific sensory neurons and are concentrated in cilia and cell bodies. Cytoplasmic, nonnuclear staining in cell bodies is punctate, suggesting that one pool of PKD-2 is localized to intracellular membranes while another is found in sensory cilia. In contrast to defects in the C. elegans autosomal recessive PKD gene osm-5 [6-8], the cilia of lov-1 and pkd-2 single mutants and of lov-1;pkd-2 double mutants are normal as judged by electron microscopy, demonstrating that lov-1 and pkd-2 are not required for ultrastructural development of male-specific sensory cilia.
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PMID:The Caenorhabditis elegans autosomal dominant polycystic kidney disease gene homologs lov-1 and pkd-2 act in the same pathway. 1155 27

Autosomal dominant polycystic kidney disease (ADPKD) accounts for 8% to 10% of patients with end-stage renal disease (ESRD) in the United States and Europe. Progressive expansion of multiple bilateral renal cysts leads to massive enlargement of the kidneys and progressive renal failure. Extrarenal manifestations of ADPKD, such as liver cysts, intracranial aneurysms, cardiac valvular disease, and perhaps diverticulosis, have been documented extensively in cross-sectional studies, but little is known about their natural history. It is thought that extrarenal aspects of ADPKD contribute to increased mortality, yet survival on dialysis of the ADPKD population surpasses that of the general dialysis population. To address this issue, we analyzed the relative risk and causes of death after ESRD in ADPKD versus nondiabetic controls using data from the United States Renal Data System. Relative risk of death from any cause, including the major extrarenal manifestations of ADPKD, was determined as a function of ESRD treatment modality (dialysis or transplantation). We found a lower total mortality rate in ADPKD ESRD patients compared with nondiabetic control ESRD patients (relative risk of death in ADPKD = 0.57; P < 0.001). Mortality rates of extrarenal complications except for polycystic liver disease were similar or lower in ADPKD patients than in nondiabetic controls. Mortality secondary to extrarenal complications was substantially lower than that secondary to cardiovascular or cerebrovascular disease.
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PMID:Survival after end-stage renal disease in autosomal dominant polycystic kidney disease: contribution of extrarenal complications to mortality. 1187 89

Autosomal dominant polycystic kidney disease (ADPKD) is common and is a major cause of renal failure. Although the genetics of ADPKD are well known and have led to the discovery of polycystins, a new protein family, the pathogenesis of the disease remains largely unknown. Recent studies have indicated that the beta-catenin signaling pathway is one of the targets of the transduction pathway controlled by the polycystins. We have generated transgenic mice that overproduce an oncogenic form of beta-catenin in the epithelial cells of the kidney. These mice developed severe polycystic lesions soon after birth that affected the glomeruli, proximal, distal tubules and collecting ducts. The phenotype of these mice mimicked the human ADPKD phenotype. Cyst formation was associated with an increase in cell proliferation and apoptosis. The cell proliferation and apoptotic indexes was increased 4-5-fold and 3-4-fold, respectively, in cystic tubules of the transgenic mice compared to that of littermate controls. Our findings provide experimental genetic evidence that activation of the Wnt/beta-catenin signaling pathway causes polycystic kidney disease and support the view that dysregulation of the Wnt/beta-catenin signaling is involved in its pathogenesis.
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PMID:Early development of polycystic kidney disease in transgenic mice expressing an activated mutant of the beta-catenin gene. 1159 4

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disorder frequently associated with renal failure, hypertension, and other abnormalities. The present study determined whether chronic caffeine intake in an animal model of this disease would affect renal structure and function and blood pressure. Heterozygous male Han:Sprague-Dawley rats with ADPKD and normal littermates were provided with either tap water or solutions of caffeine to drink, starting at 1 month of age. When rats were aged 6 months, glomerular filtration rate (GFR) and mean arterial blood pressure (MAP) were measured under Inactin (Byk Gulden, Konstanz, Germany) anesthesia. Caffeine intake had no effect on GFR or cyst development in rats with PKD. MAP was greater in rats with PKD than normal rats and was increased more by caffeine. The hypertensive effect of chronic caffeine intake could not be ascribed to direct pressor effects of angiotensin II. Based on our finding that caffeine exacerbates hypertension in rats with PKD, it may be prudent for patients with ADPKD to limit coffee consumption to four or fewer cups of caffeinated coffee per day, pending studies of humans.
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PMID:Chronic caffeine consumption exacerbates hypertension in rats with polycystic kidney disease. 1168 64

Autosomal dominant polycystic kidney disease (ADPKD) is a widespread genetic disease that causes renal failure. One of the genes that is responsible for this disease, PKD1, has been identified and characterized. Many mutations of the PKD1 gene have been identified in the Caucasian population. We investigated the occurrence of mutations in this gene in the Japanese population. We analyzed each exon in the 3' single copy region of the gene between exons 35 and 46 in genomic DNA obtained from 69 patients, using a PCR-based direct sequencing method. Four missense mutations (T3509M, G3559R, R3718Q, R3752W), one deletion mutation (11307del61bp) and one polymorphism (L3753L) were identified, and their presence confirmed by allele-specific oligonucleotide (ASO) hybridization. These were novel mutations, except for R3752W, and three of them were identified in more than two families. Mutation analysis of the PKD1 gene in the Japanese population is being reported for the first time.
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PMID:Mutational analysis within the 3' region of the PKD1 gene in Japanese families. 1169 39

Autosomal dominant polycystic kidney disease is a common inherited disorder, which is characterised by the formation of fluid-filled cysts in both kidneys that leads to progressive renal failure. Mutations in two genes, PKD1 and PKD2, are associated with the disorder. We describe the various factors that cause variation in disease progression between patients. These include whether the patient has a germline mutation in the PKD1 or in the PKD2 gene, and the nature of the mutation. Detection of mutations in PKD1 is complicated, but the total number identified is rising and will enable genotype-to-phenotype studies. Another factor affecting disease progression is the occurrence of somatic mutations in PKD genes. Furthermore, modifying genes might directly affect the function of polycystins by affecting the rate of somatic mutations or the rate of protein interactions, or they might affect cystogenesis itself or clinical factors associated with disease progression. Finally, environmental factors that speed up or slow down progress towards chronic renal failure have been identified in rodents.
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PMID:Autosomal dominant polycystic kidney disease: modification of disease progression. 1170 10

Autosomal dominant polycystic kidney disease (ADPKD) has aroused great interest these last years, especially after the discovery of the genes responsible for this disease. It remains a frequent cause of chronic renal failure (CRF). In this work we report the results of a multi-centre retrospective study. The data relates to 41 centres of nephrology and dialysis in Morocco, 308 Moroccan families and 420 observations. We have tried to determine the frequency of this pathology in Morocco, its complications and difficulties in taking care of it. The average age of the discovery of ADPKD was 46 +/- 3 years and the sex ratio was of 1.08. The ADPKD frequency among Moroccans who undergo dialysis was 6.5%. Pain was the most frequent symptom which revealed the disease (21%); while renal failure at different stages was found in 17% of the patients and high blood pressure (HBP) in 11%. The clinic diagnosis was confirmed by echography in 95% of cases. The association with a hepatic cysts was found in 17.8% of the cases. In addition, to HBR and urinary tract infection, the complications were largely dominated by renal chronic failure and the difficulties in taking care of it because of economic problems. Through this the authors discuss and report the profile and the prognostics of this infection in our society, with a special focus on the evolution of the renal function, the delay in the diagnosis and the management.
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PMID:[Autosomal dominant polycystic kidney disease (ADPKD). in Morocco. Multicenter study about 308 families]. 1201 54

I want to thank the organizers for inviting me to present the Jeremiah Metzger Lecture at this, the 114th meeting of the ACCA. It is a high honor, indeed, to join a list of very distinguished predecessors. And for this opportunity to tell you about my passion in medicine and science, I am most grateful. Most of you in this room have passing knowledge of polycystic kidney disease, probably hearing about it in your medical school Pathology course where you were shown an especially grotesque, enormously enlarged kidney either encased in transparent plastic or submerged in a bucket of formaldehyde. In that minute or two when PKD was discussed in lecture, you may have been told that this is a rare, hereditary disorder that causes kidney failure and that nothing can be done to alter that course. Unless you chose to specialize in General Internal Medicine or Nephrology, you may not have encountered PKD again until today, despite the fact there are approximately 600,000 PKD patients in the USA and over 10,000,000 worldwide, and it accounts for approximately 5% of non-diabetic dialysis and renal transplant patients (Table 1). I might have overlooked PKD as well had it not been for a close friend that I grew up with who had inherited the disease from his mother. He was very open about the fact that he had cysts in his kidneys that caused bleeding into the urine from time to time, especially after a solid hit during a game of tackle football. We remained friends long after I left home for college and medical school. At an early stage of my research career in medicine, while wondering how nephron segments processed glomerular filtrate, I inadvertently discovered that renal tubules could secrete as well as reabsorb salt and water. This was quite an unexpected finding at the time (1). But it occurred to [table: see text] me that this might be a means to fill renal cysts with fluid and so I decided to learn more about the pathology and pathogenesis of PKD. This didn't take long, because there wasn't much literature on the subject. The clinical manifestations of PKD were described in the 19th century European medical literature and Sir William Osler had published on the topic in this country, but by and large only a few descriptions of small groups of patients were reported through the middle of the 20th century. In 1957, Dalgaard (2) reported in a classic doctoral thesis that the most common type of hereditary PKD is transmitted as an autosomal dominant trait (ADPKD) with complete penetrance. It is a bilateral renal condition, but cysts also occur in the liver (approximately 60%), pancreas (approximately 10%) and various other organs, and it is associated with cerebral aneurysms in approximately 5% of patients. A recessive form that affects infants and children primarily (ARPKD), is much rarer than ADPKD and commonly leads to death in infancy in association with massively enlarged kidneys (Table 2). I was also attracted to the study of PKD because the etiology was not in question: it had to be mutated DNA. Yet that fact proved to be a hindrance in attaining research support. As some of you will recall, not too long ago genetic diseases were viewed by kidney-oriented NIH review panels to be incurable. I was advised that a young scientist's time would be better spent determining how the kidneys excrete salt and water. Fortunately, the era of molecular genetics and biology was upon us, and we quickly learned that uncommon genetic disorders could lead to the discovery of novel molecules in metabolic and structural pathways. And that is just what happened in the PKD field. The autosomal dominant form of PKD led to the discovery of a unique family of highly complex proteins long before they would have been selected from a gene or proteomic micro-array by some desperate graduate student or fellow. The chromosomal location of the major ADPKD genotype, PKD1, was defined in 1985 (3), a date that marks the beginning of a remarkable period of discovery.
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PMID:The Jeremiah Metzger Lecture. Polycystic kidney disease: old disease in a new context. 1205 11


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