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X-linked recessive nephrolithiasis with renal failure.

P A Frymoyer1, S J Scheinman, P B Dunham

  • 1Department of Medicine, State University of New York Health Science Center, Syracuse 13210.

The New England Journal of Medicine
|September 5, 1991
PubMed
Summary

This study identifies a new X-linked recessive nephrolithiasis with renal failure in a large family. The disease causes kidney stones, concentrating defects, and renal insufficiency in males.

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Area of Science:

  • Nephrology
  • Medical Genetics

Background:

  • Hereditary nephrolithiasis can stem from various genetic disorders.
  • A large kindred with hereditary nephrolithiasis, urinary concentrating defects, nephrocalcinosis, renal insufficiency, and electrolyte wasting was studied.

Observation:

  • The kindred comprised 162 members across six generations, with nine affected males inheriting the condition maternally.
  • Patients presented in childhood with calcium nephrolithiasis and proteinuria, progressing to nephrocalcinosis and renal insufficiency.
  • Renal biopsies showed tubular atrophy, interstitial fibrosis, and glomerulosclerosis, distinct from other hereditary nephritis.

Findings:

  • The inheritance pattern was X-linked recessive, with affected males not transmitting the gene to sons, but daughters becoming carriers.
  • Abnormalities in renal excretion of calcium, phosphate, potassium, and uric acid were noted in adult members.

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  • The disease did not recur in one patient seven years post-renal transplant.
  • Implications:

    • This research describes a novel form of X-linked recessive hereditary renal disease.
    • Physiologic abnormalities appear to manifest after the onset of nephrolithiasis and renal insufficiency.