Portal de Periódicos da CAPES

Clinical impact of genomic testing in patients with suspected monogenic kidney disease

2020; Elsevier BV; Volume: 23; Issue: 1 Linguagem: Inglês

10.1038/s41436-020-00963-4

1530-0366

Kushani Jayasinghe, Zornitza Stark, Peter G. Kerr, Clara Gaff, Melissa Martyn, John Whitlam, Belinda Creighton, Elizabeth Donaldson, Matthew F. Hunter, Anna Jarmolowicz, Lilian Johnstone, Emma Krzesinski, Sebastian Lunke, Elly Lynch, Kathy Nicholls, Chirag Patel, Yael Prawer, Jessica Ryan, Emily See, Andrew Talbot, Alison H. Trainer, Rigan Tytherleigh, Giulia Valente, Mathew Wallis, Louise Wardrop, Kirsty West, Susan M. White, Ella Wilkins, Andrew Mallett, Catherine Quinlan,

Genomics and Rare Diseases

To determine the diagnostic yield and clinical impact of exome sequencing (ES) in patients with suspected monogenic kidney disease.We performed clinically accredited singleton ES in a prospectively ascertained cohort of 204 patients assessed in multidisciplinary renal genetics clinics at four tertiary hospitals in Melbourne, Australia.ES identified a molecular diagnosis in 80 (39%) patients, encompassing 35 distinct genetic disorders. Younger age at presentation was independently associated with an ES diagnosis (p < 0.001). Of those diagnosed, 31/80 (39%) had a change in their clinical diagnosis. ES diagnosis was considered to have contributed to management in 47/80 (59%), including negating the need for diagnostic renal biopsy in 10/80 (13%), changing surveillance in 35/80 (44%), and changing the treatment plan in 16/80 (20%). In cases with no change to management in the proband, the ES result had implications for the management of family members in 26/33 (79%). Cascade testing was subsequently offered to 40/80 families (50%).In this pragmatic pediatric and adult cohort with suspected monogenic kidney disease, ES had high diagnostic and clinical utility. Our findings, including predictors of positive diagnosis, can be used to guide clinical practice and health service design.