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Published on: October 11, 2014
Monogenic Kidney Diseases in Kidney Transplantation
Valentine Gillion1,2, Arnaud Devresse1,2,3, Eric Olinger4
1Department of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium.
Abstract:
Monogenic kidney diseases are involved in up to 15% of end-stage kidney diseases (ESKDs) in adults, and in 70 % of pediatric patients. When these disorders lead to kidney failure (KF), kidney transplantation (KT) is the preferred mode of replacement therapy. KT requires specific considerations depending on the nature of the genetic disorder, the potential oncological risk, the risk of recurrence in the graft, the possibility of specific complications of immunosuppression, and the issue of living donation. The availability of genetic testing should play an increasing role in the evaluation of patients or related living donor candidates before transplantation, relevant for the pretransplantation and posttransplantation management.
Insights
Monogenic kidney diseases significantly contribute to kidney failure, making kidney transplantation crucial. Genetic testing is vital for pre- and post-transplant management in these patients.
Area of Science:
- Nephrology
- Genetics
- Transplantation Immunology
Background:
- Monogenic kidney diseases account for up to 15% of adult and 70% of pediatric end-stage kidney diseases.
- Kidney transplantation is the primary treatment for kidney failure caused by these genetic disorders.
- Transplantation in monogenic kidney disease necessitates careful consideration of genetic factors, oncological risks, recurrence, immunosuppression complications, and living donation.
Purpose of the Study:
- To highlight the critical role of genetic testing in the pre- and post-transplantation management of patients with monogenic kidney diseases.
- To emphasize the unique considerations for kidney transplantation in the context of inherited kidney disorders.
Main Methods:
- Review of current literature on monogenic kidney diseases and kidney transplantation.
- Analysis of the impact of genetic diagnosis on transplantation outcomes and management strategies.
Main Results:
- Genetic testing is essential for evaluating patients and living donor candidates prior to kidney transplantation.
- Understanding the specific genetic disorder guides decisions regarding immunosuppression, risk assessment, and potential recurrence in the graft.
- Genetic information impacts the management of potential complications and the consideration of living donation.
Conclusions:
- Genetic testing should be integrated into the routine evaluation of patients with end-stage kidney disease, particularly those with suspected monogenic causes.
- Personalized pre- and post-transplant management strategies informed by genetic testing can optimize outcomes for kidney transplant recipients with monogenic kidney diseases.
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