Kidney International

TABLE 1

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Genetics of hypercalciuric stone forming diseases

O Devuyst and Y Pirson

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Table 1. Monogenic human disorders associated with renal hypercalciuria and nephrolithiasis

Mode of inheritance disease MIM Gene, protein, function Segment Pathophysiology, renal manifestations Extra-renal manifestations
X-linked
 Dent's disease (1) (X-linked recessive nephrolithiasis; X-linked hypophosphatemic rickets; idiopathic low-molecular-weight proteinuria)300009 CLCN5, ClC-5 Cl-/H+ exchangerPT, TAL, ICalpha Trafficking defect, defective endocytosis
PT dysfunction, renal Fanconi syndrome
Nephrocalcinosis, stones
Impaired urine acidification
Renal failure
Rickets
 Lowe's syndrome (oculo-cerebro-renal syndrome)
Dent's disease (2)
309000
300555
OCRL, OCRL1
Phosphatidylinositol 4,5-bisphosphate-5-phosphatase
PTPT dysfunction, renal Fanconi syndrome
Proximal RTA, metabolic acidosis
Nephrocalcinosis, stones
Mental retardation, cataract, rickets, cryptorchidism, neuromuscular and behavioral abnormalities, growth delay
Autosomal dominant
 Autosomal dominant hypocalcemia (ADH) (Bartter-like syndrome type V)146200 CASR, CaSR
Calcium-sensing receptor
PT, TAL, DCT, CDGain-of-function mutations
Low serum PTH
Hypocalcemia, hypercalciuria
Nephrocalcinosis, stones (vitamin D)
Salt-losing nephropathy, hypokalemia
Neuromuscular manifestations of hypocalcemia, seizures, basal ganglia calcifications
 Distal renal tubular acidosis (dRTA, RTA type I)179800 SLC4A1, AE1
Cl-/HCO3 - exchanger
ICalpha Impaired anion exchange in ICalpha
Metabolic acidosis, hypercalciuria
Nephrocalcinosis, stones
Osteomalacia, rickets, growth retardation
Autosomal recessive
 Antenatal Bartter's syndrome type I (hyperprostaglandin E syndrome)601678 SLC12A1, NKCC2
Na+-K+-2Cl- co-transporter 2
TALProfound salt-wasting, polyuria
Metabolic alkalosis, hypokalemia
Hyperprostaglandinuria
Hypercalciuria, nephrocalcinosis
Polyhydramnios, prematurity, fever, vomiting, diarrhea, osteopenia
 Antenatal Bartter's syndrome type II (hyperprostaglandin E syndrome 2)241200 KCNJ1, ROMK
K+ channel
TAL, CDProfound salt-wasting, polyuria
Transient (neonatal) hyperkalemia
Metabolic alkalosis, hypokalemia
Hyperprostaglandinuria
Hypercalciuria, nephrocalcinosis
Polyhydramnios, prematurity, Fever, vomiting, diarrhea, osteopenia
 Bartter's syndrome type III (classic Bartter's syndrome)607364 CLCNKB, ClC-Kb
Cl- channel
TAL, DCTHighly variable phenotype
Variable calciuria levels, stones
Variable (polyhydramnios)
 Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC)248250 CLDN16 (PCLN1),
Claudin-16, paracellin-1
Tight junction protein
TAL, DCTImpaired paracellular transport of calcium and magnesium
Calcium and magnesium wasting, renal failure, nephrocalcinosis, stones
Incomplete distal tubular acidosis
Convulsions, tetany, chondrocalcinosis, neuromuscular manifestations
 Distal renal tubular acidosis (dRTA with progressive nerve deafness)267300 ATP6V1B1, V1 subunit B1
Subunit of V-ATPase
ICalpha Impaired urine acidification
Metabolic acidosis, kaliuresis
Hypercalciuria, nephrocalcinosis, stones
Sensorineural hearing loss, hypokalemic paralysis, rickets, growth impairment
 Distal renal tubular acidosis (dRTA with preserved hearing or late onset hearing loss)602722 ATPV0A4, V0 subunit a4
Subunit of V-ATPase
ICalpha  Normal hearing or late onset sensorineural hearing loss, paralysis, rickets, growth impairment

 CD, collecting duct; DCT, distal convoluted tubule; dRTA, distal renal tubular acidosis; ICalpha, intercalated cell (alpha-type); RTA, renal tubular acidosis; PT, proximal tubule; TAL, thick ascending limb of Henle's loop; V-ATPase, vacuolar H+-ATPase.

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