2026-04-13T05:58:02Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/106172025-10-24T10:18:47Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:18:47Z urn:hdl:11351/10617 Genetic testing in focal segmental glomerulosclerosis: in whom and when? Tato, Ana María Carrera, Noa García-Murias, María Shabaka, Amir Ávila, Ana MORA MORA, MARIA TERESA García-Carro, Clara Cromosomes humans - Anomalies - Diagnòstic Glomerulosclerosi - Aspectes genètics Glomerulosclerosi - Diagnòstic DISEASES::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Nephritis::Glomerulonephritis::Glomerulosclerosis, Focal Segmental DISEASES::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Nephrosis::Nephrotic Syndrome Other subheadings::Other subheadings::Other subheadings::/genetics ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Genetic Testing ENFERMEDADES::enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::nefritis::glomerulonefritis::glomeruloesclerosis focal ENFERMEDADES::enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::nefrosis::síndrome nefrótico Otros calificadores::Otros calificadores::Otros calificadores::/genética TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::pruebas genéticas Hereditary diseases; Nephrotic syndrome; Steroid-resistant Enfermedades hereditarias; Síndrome nefrótico; Resistente a los esteroides Malalties hereditàries; Síndrome nefròtica; Resistent als esteroides Background Genetic causes are increasingly recognized in patients with focal segmental glomerulosclerosis (FSGS), but it remains unclear which patients should undergo genetic study. Our objective was to determine the frequency and distribution of genetic variants in steroid-resistant nephrotic syndrome FSGS (SRNS-FSGS) and in FSGS of undetermined cause (FSGS-UC). Methods We performed targeted exome sequencing of 84 genes associated with glomerulopathy in patients with adult-onset SRNS-FSGS or FSGS-UC after ruling out secondary causes. Results Seventy-six patients met the study criteria; 24 presented with SRNS-FSGS and 52 with FSGS-UC. We detected FSGS-related disease-causing variants in 27/76 patients (35.5%). There were no differences between genetic and non-genetic causes in age, proteinuria, glomerular filtration rate, serum albumin, body mass index, hypertension, diabetes or family history. Hematuria was more prevalent among patients with genetic causes. We found 19 pathogenic variants in COL4A3–5 genes in 16 (29.3%) patients. NPHS2 mutations were identified in 6 (16.2%) patients. The remaining cases had variants affecting INF2, OCRL, ACTN4 genes or APOL1 high-risk alleles. FSGS-related genetic variants were more common in SRNS-FSGS than in FSGS-UC (41.7% vs 32.7%). Four SRNS-FSGS patients presented with NPHS2 disease-causing variants. COL4A variants were the most prevalent finding in FSGS-UC patients, with 12 patients carrying disease-causing variants in these genes. Conclusions FSGS-related variants were detected in a substantial number of patients with SRNS-FSGS or FSGS-UC, regardless of age of onset of disease or the patient's family history. In our experience, genetic testing should be performed in routine clinical practice for the diagnosis of this group of patients. This work was supported by grants from the Fundación Íñigo Álvarez de Toledo, the Instituto de Salud Carlos III (PI18/00 378 under FIS/FEDER and RD21/0005/0020-RICORS funds to M.A.G.-G.; RD21/10 005/0001-RICORS to G.F.-J.) and the Xunta de Galicia (IN607B-2016/020 to M.A.G.-G., funded by the European Union “NextGenerationEU” Facility for recovery and resilience). None of the funders had any role in study design, data collection, analysis, reporting or the decision to submit for publication. 2025-10-24T10:18:47Z 2025-10-24T10:18:47Z 2023-11-16T13:37:25Z 2023-11-16T13:37:25Z 2023-11 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/10617 Clinical Kidney Journal;16(11) https://doi.org/10.1093/ckj/sfad193 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess Oxford University Press Scientia