При редких наследственных заболеваниях могут наблюдаться гломерулопатии, тубулопатии, поликистоз, аномалии почек и мочевыводящих путей, уролитиаз, злокачественные или доброкачественные опухоли. Наследственные нефропатии в первую очередь следует предполагать при появлении признаков поражения почек в детском, подростковом или молодом возрасте и/или при наличии семейного анамнеза. При системных заболеваниях важное диагностическое значение имеют внепочечные проявления (например, нейросенсорная тугоухость при синдроме Альпорта или отложение кристаллов цистина в роговице при нефропатическом цистинозе). Для подтверждения диагноза моногенного наследственного заболевания проводят молекулярно-генетическое исследование. При некоторых орфанных заболеваниях, поражающих почки, таких как болезнь Фабри, цистиноз, первичная гипероксалурия 1-го типа и атипичный гемолитико-уремический синдром, возможна специфическая патогенетическая терапия.
Various rare inherited disorders can be associated with kidney involvement, including glomerulopathies, tubulopathies, multiple cysts, congenital anomalies of the kidneys and urinary tract, urolithiasis, malignant and benign tumors. Genetic nephropathy should be always considered in children, adolescents and young patients with the kidneys or urinary tract disorders and/or patients with positive family anamnesis. Extrarenal manifestations can be a valuable clue for diagnosis of certain hereditary diseases, e.g. neurosensory deafness in Alport syndrome or photofobia in nephropathic cystinosis. Diagnosis of monogenic inherited diseases should be verified by genetic testing. Specific drugs are available for treatment of certain hereditary diseases involving kidney, e.g. Fabry disease, cystinosis, primary hyperoxaluria I type and atypical hemolytic uremic syndrome.
1. Joly D, Béroud C, Grünfeld JP. Rare inherited disorders with renal involvement-approach to the patient. Kidney Int. 2015;87(5):901-8. DOI:10.1038/ki.2014.432
2. Nguengang Wakap S, Lambert DM, Orly A, et al. Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur J Hum Genet. 2020;28(2):165-73. DOI:10.1038/s41431-019-0508-0
3. Boycott KM, Lau LP, Cutillo CM, Austin CP. International collaborative actions and transparency to understand, diagnose, and develop therapies for rare diseases. EMBO Mol Med. 2019;11(5):e10486. DOI:10.15252/emmm.201910486
4. van der Ven AT, Vivante A, Hildebrandt F. Novel insights into the pathogenesis of monogenic congenital anomalies of the kidney and urinary tract. J Am Soc Nephrol. 2018;29(1):36-50. DOI:10.1681/ASN.2017050561
5. Murugapoopathy V, Gupta IR. A primer on congenital anomalies of the kidneys and urinary tracts (CAKUT). Clin J Am Soc Nephrol. 2020;15(5):723-31. DOI:10.2215/CJN.12581019
6. McConnachie DJ, Stow JL, Mallett AJ. Ciliopathies and the kidney: A review. Am J Kidney Dis. 2021;77(3):410-9. DOI:10.1053/j.ajkd.2020.08.012
7. Руденко Т.Е., Бобкова И.Н., Ставровская Е.В. Современные подходы к консервативной терапии поликистозной болезни почек. Терапевтический архив. 2019;91(6):116-23 [Rudenko TE, Bobkova IN, Stavrovskaya EV. Modern approaches to conservative therapy of polycystic kidney disease. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(6):116-23 (in Russian)]. DOI:10.26442/00403660.2019.06.000299
8. Qiu J, Germino GG, Menezes LF. Mechanisms of cyst development in polycystic kidney disease. Adv Kidney Dis Health. 2023;30(3):209-19. DOI:10.1053/j.akdh.2023.03.001
9. Lu J, Xu W, Gong L, et al. Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis. Int Urol Nephrol. 2023;55(3):631-40. DOI:10.1007/s11255-022-03353-8
10. Hogan MC, Masyuk TV. Concurrent targeting of vasopressin receptor 2 and somatostatin receptors in autosomal dominant polycystic kidney disease: A promising approach for autosomal dominant polycystic kidney disease treatment? Clin J Am Soc Nephrol. 2023;18(2):154-6. DOI:10.2215/CJN.0000000000000055
11. Bergmann C, Guay-Woodford LM, Harris PC, et al. Polycystic kidney disease. Nat Rev Dis Primers. 2018;4(1):50. DOI:10.1038/s41572-018-0047-y
12. Singh S, Chaurasia A, Gopal N, et al. Treatment strategies for hereditary kidney cancer: current recommendations and updates. Discov Med. 2022;34(173):205-20.
13. Nair N, Chakraborty R, Mahajan Z, et al. Renal manifestations of tuberous sclerosis complex. J Kidney Cancer VHL. 2020;7(3):5-19. DOI:10.15586/jkcvhl.2020.131
14. Varshney N, Kebede AA, Owusu-Dapaah H, et al. A review of von Hippel-Lindau syndrome. J Kidney Cancer VHL. 2017;4(3):20-9. DOI:10.15586/jkcvhl.2017.88
15. Decks E. Belzutifan: first approval. Drugs. 2021;81(16):1921-7. DOI:10.1007/s40265-021-01606-x
16. Gregorio V, Caparali EB, Shojaei A, et al. Alport syndrome: clinical spectrum and therapeutic advances. Kidney Med. 2023;5(5):100631. DOI:10.1016/j.xkme.2023.100631
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18. Dorval G, Servais A, Boyer O. The genetics of steroid-resistant nephrotic syndrome in children. Nephrol Dial Transplant. 2022;37(4):648-51. DOI:10.1093/ndt/gfaa221
19. Boyer O, Dorval G, Servais A. The genetics of steroid-resistant nephrotic syndrome in adults. Nephrol Dial Transplant. 2021;36(9):1600-2. DOI:10.1093/ndt/gfz257
20. Lepori N, Zand L, Sethi S, et al. Clinical and pathological phenotype of genetic causes of focal segmental glomerulosclerosis in adults. Clin Kidney J. 2018;11(2):179-90. DOI:10.1093/ckj/sfx143
21. Sadowski CE, Lovric S, Ashraf S, et al. the SRNS Study Group. A single-gene cause in 29.5% of cases of steroid-resistant nephrotic syndrome. J Am Soc Nephrol. 2015;26:1279-89. DOI:10.1681/ASN.2014050489
22. Santín S, Bullich G, Tazón-Vega B, et al. Clinical utility of genetic testing in children and adults with steroid-resistant nephrotic syndrome. Clin J Am Soc Nephrol. 2011;6(5):1139-48. DOI:10.2215/CJN.05260610
23. Econimo L, Schaeffer C, Zeni L, et al. Autosomal dominant tubulointerstitial kidney disease: an emerging cause of genetic CKD. Kidney Int Rep. 2022;7(11):2332-44. DOI:10.1016/j.ekir.2022.08.012
24. Mabillard H, Sayer JA, Olinger E. Clinical and genetic spectra of autosomal dominant tubulointerstitial kidney disease. Nephrol Dial Transplant. 2023;38(2):271-82. DOI:10.1093/ndt/gfab268
25. Downie ML, Lopez Garcia SC, Kleta R, Bockenhauer D. Inherited tubulopathies of the kidney: insights from genetics. Clin J Am Soc Nephrol. 2021;16(4):620-30. DOI:10.2215/CJN.14481119
26. Kermond R, Mallett A, McCarthy H. A clinical approach to tubulopathies in children and young adults. Pediatr Nephrol. 2023;38(3):651-62. DOI:10.1007/s00467-022-05606-1
27. Чеботарева Н.В., Цыгин А.Н., Буланов Н.М., и др. Синдром Фанкони у взрослых и детей. Клиническая фармакология и терапия. 2022;31(1):69-74 [Chebotareva NV, Tsygin AN, Bulanov NM, et al. Fanconi syndrome in adults and children. Klinicheskaya Farmakologiya i Terapiya. 2022;31(1):69-74 (in Russian)]. DOI:10.32756/ 0869-5490-2022-1-69-74
28. Besouw MTP, Kleta R, Bockenhauer D. Bartter and Gitelman syndromes: questions of class. Pediatr Nephrol. 2020;35:1815-24. DOI:10.1007/s00467-019-04371-y
29. Моисеев С.В., Тао Е.А., Моисеев А.С., и др. Клинические проявления и исходы болезни Фабри у 150 взрослых пациентов. Клиническая фармакология и терапия. 2021;30(3):43-51 [Moiseev SV, Tao EA, Moiseev AS, et al. Clinical manifestations and outcomes of Fabry disease in 150 adult patients. Klinicheskaya Farmakologiya i Terapiya. 2021;30(3):43-51 (in Russian)]. DOI:10.32756/ 0869-5490-2021-3-43-51
30. Моисеев А.С., Буланов Н.М., Тао Е.А., и др. Эффективность и безопасность длительной ферментозаместительной терапии агалсидазой альфа и агалсидазой бета у взрослых пациентов с болезнью Фабри. Клиническая фармакология и терапия. 2022;31(4):28-34 [Moiseev AS, Bulanov NM, Tao EA, et al. Efficacy and safety of long-term enzyme replacement therapy with agalsidase alfa or agalsidase beta in adult patients with Fabry disease. Klinicheskaya Farmakologiya i Terapiya. 2022;31(4):28-34 (in Russian)]. DOI:10.32756/0869-5490-2022-4-28-34
31. Чеботарева Н.В., Цыгин А.Н., Буланов Н.М., и др. Цистиноз: патогенез, клинические проявления и лечение. Клиническая фармакология и терапия. 2021;30(1):80-8 [Chebotareva NV, Tsygin AN, Bulanov NM, et al. Cystinosis: pathogenesis, clinical features and treatment. Klinicheskaya Farmakologiya i Terapiya. 2021;30(1):80-8 (in Russian)]. DOI:10.32756/ 0869-5490-2021-1-80-88
32. Emma F, van’t Hoff W, Hohenfellner K, et al. An international cohort study spanning five decades assessed outcomes of nephropathic cystinosis. Kidney Int. 2021;100(5):1112-23. DOI:10.1016/j.kint.2021.06.019
33. Shee K, Stoller ML. Perspectives in primary hyperoxaluria – historical, current and future clinical interventions. Nat Rev Urol. 2022;19(3):137-46. DOI:10.1038/s41585-021-00543-4
34. Michael M, Groothoff JW, Shasha-Lavsky H, et al. Lumasiran for advanced primary hyperoxaluria type 1: phase 3 ILLUMINATE-C trial. Am J Kidney Dis. 2023;81(2):145-55. DOI:10.1053/j.ajkd.2022.05.012
35. Рамеев В.В., Моисеев С.В., Козловская Л.В. AA-амилоидоз при аутовоспалительных заболеваниях. Клиническая фармакология и терапия. 2021;30(4):52-61 [Rameev VV, Moiseev SV, Kozlovskaya LV. AA amyloidosis in autoinflammatory diseases. Klinicheskaya Farmakologiya i Terapiya. 2021;30(4):52-61 (in Russian)].
DOI:10.32756/0869-54902021-4-52-61
36. Моисеев С.В., Рамеев В.В. Дифференциальный диагноз системных аутовоспалительных заболеваний. Клиническая фармакология и терапия. 2022;31(2):5-13 [Moiseev SV, Rameev VV. Differential diagnosis of systemic autoinflammatory diseases. Klinicheskaya Farmakologiya i Terapiya. 2022;31(2):5-13 (in Russian)].
DOI:10.32756/ 0869-5490-2022-2-5-13
37. Damy T, Garcia-Pavia P, Hanna M, et al. Efficacy and safety of tafamidis doses in the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) and long-term extension study. Europ J Heart Fail. 2021;23:277-85. DOI:10.1002/ejhf.2027
38. Коротчаева Ю.В., Козловская Н.Л., Демьянова К.А., и др. Атипичный гемолитико-уремический синдром: клиническая картина, диагностика и лечение. Клиническая фармакология и терапия. 2022;31(2):43-50 [Korotchaeva YuV, Kozlovskaya NL, Demyanova KA, et al. Atypical hemolytic-uremic syndrome: clinical presentation, diagnosis and treatment. Klinicheskaya Farmakologiya i Terapiya. 2022;31(2):43-50 (in Russian)]. DOI:10.32756/0869-54902022-2-43-50
39. Козловская Н.Л., Прокопенко Е.И., Эмирова Х.М., Серикова С.Ю. Клинические рекомендации по диагностике и лечению атипичного гемолитико-уремического синдрома. Нефрология и диализ. 2015;17(3):242-64 [Kozlovskaya NL, Prokopenko EI, Emirova KhM, Serikova SYu. Clinical guidelines for diagnosis and treatment of atypical hemolytic uremic syndrome. Nephrology and Dialysis. 2015;17(3):242-64 (in Russian)]. DOI:10.32756/0869-5490-2022-2-43-50
40. Granhøj J, Tougaard B, Lildballe DL, Rasmussen M. Family history is important to identify patients with monogenic causes of adult-onset chronic kidney disease. Nephron. 2022;146(1):49-57. DOI:10.1159/000518175
41. Moiseev S, Tao E, Moiseev A, et al. The benefits of family screening in rare diseases: genetic testing reveals 165 new cases of Fabry disease among at-risk family members of 83 index patients. Genes (Basel). 2022;13(9):1619. DOI:10.3390/genes13091619
________________________________________________
1. Joly D, Béroud C, Grünfeld JP. Rare inherited disorders with renal involvement-approach to the patient. Kidney Int. 2015;87(5):901-8. DOI:10.1038/ki.2014.432
2. Nguengang Wakap S, Lambert DM, Orly A, et al. Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur J Hum Genet. 2020;28(2):165-73. DOI:10.1038/s41431-019-0508-0
3. Boycott KM, Lau LP, Cutillo CM, Austin CP. International collaborative actions and transparency to understand, diagnose, and develop therapies for rare diseases. EMBO Mol Med. 2019;11(5):e10486. DOI:10.15252/emmm.201910486
4. van der Ven AT, Vivante A, Hildebrandt F. Novel insights into the pathogenesis of monogenic congenital anomalies of the kidney and urinary tract. J Am Soc Nephrol. 2018;29(1):36-50. DOI:10.1681/ASN.2017050561
5. Murugapoopathy V, Gupta IR. A primer on congenital anomalies of the kidneys and urinary tracts (CAKUT). Clin J Am Soc Nephrol. 2020;15(5):723-31. DOI:10.2215/CJN.12581019
6. McConnachie DJ, Stow JL, Mallett AJ. Ciliopathies and the kidney: A review. Am J Kidney Dis. 2021;77(3):410-9. DOI:10.1053/j.ajkd.2020.08.012
7. Rudenko TE, Bobkova IN, Stavrovskaya EV. Modern approaches to conservative therapy of polycystic kidney disease. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(6):116-23 (in Russian). DOI:10.26442/00403660.2019.06.000299
8. Qiu J, Germino GG, Menezes LF. Mechanisms of cyst development in polycystic kidney disease. Adv Kidney Dis Health. 2023;30(3):209-19. DOI:10.1053/j.akdh.2023.03.001
9. Lu J, Xu W, Gong L, et al. Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis. Int Urol Nephrol. 2023;55(3):631-40. DOI:10.1007/s11255-022-03353-8
10. Hogan MC, Masyuk TV. Concurrent targeting of vasopressin receptor 2 and somatostatin receptors in autosomal dominant polycystic kidney disease: A promising approach for autosomal dominant polycystic kidney disease treatment? Clin J Am Soc Nephrol. 2023;18(2):154-6. DOI:10.2215/CJN.0000000000000055
11. Bergmann C, Guay-Woodford LM, Harris PC, et al. Polycystic kidney disease. Nat Rev Dis Primers. 2018;4(1):50. DOI:10.1038/s41572-018-0047-y
12. Singh S, Chaurasia A, Gopal N, et al. Treatment strategies for hereditary kidney cancer: current recommendations and updates. Discov Med. 2022;34(173):205-20.
13. Nair N, Chakraborty R, Mahajan Z, et al. Renal manifestations of tuberous sclerosis complex. J Kidney Cancer VHL. 2020;7(3):5-19. DOI:10.15586/jkcvhl.2020.131
14. Varshney N, Kebede AA, Owusu-Dapaah H, et al. A review of von Hippel-Lindau syndrome. J Kidney Cancer VHL. 2017;4(3):20-9. DOI:10.15586/jkcvhl.2017.88
15. Decks E. Belzutifan: first approval. Drugs. 2021;81(16):1921-7. DOI:10.1007/s40265-021-01606-x
16. Gregorio V, Caparali EB, Shojaei A, et al. Alport syndrome: clinical spectrum and therapeutic advances. Kidney Med. 2023;5(5):100631. DOI:10.1016/j.xkme.2023.100631
17. Aksenova ME. Alport syndrome: our knowledge update. Nephrology. 2021;25(3):75-83 (in Russian). DOI:10.36485/1561-6274-2021-25-3-75-83
18. Dorval G, Servais A, Boyer O. The genetics of steroid-resistant nephrotic syndrome in children. Nephrol Dial Transplant. 2022;37(4):648-51. DOI:10.1093/ndt/gfaa221
19. Boyer O, Dorval G, Servais A. The genetics of steroid-resistant nephrotic syndrome in adults. Nephrol Dial Transplant. 2021;36(9):1600-2. DOI:10.1093/ndt/gfz257
20. Lepori N, Zand L, Sethi S, et al. Clinical and pathological phenotype of genetic causes of focal segmental glomerulosclerosis in adults. Clin Kidney J. 2018;11(2):179-90. DOI:10.1093/ckj/sfx143
21. Sadowski CE, Lovric S, Ashraf S, et al. the SRNS Study Group. A single-gene cause in 29.5% of cases of steroid-resistant nephrotic syndrome. J Am Soc Nephrol. 2015;26:1279-89. DOI:10.1681/ASN.2014050489
22. Santín S, Bullich G, Tazón-Vega B, et al. Clinical utility of genetic testing in children and adults with steroid-resistant nephrotic syndrome. Clin J Am Soc Nephrol. 2011;6(5):1139-48. DOI:10.2215/CJN.05260610
23. Econimo L, Schaeffer C, Zeni L, et al. Autosomal dominant tubulointerstitial kidney disease: an emerging cause of genetic CKD. Kidney Int Rep. 2022;7(11):2332-44. DOI:10.1016/j.ekir.2022.08.012
24. Mabillard H, Sayer JA, Olinger E. Clinical and genetic spectra of autosomal dominant tubulointerstitial kidney disease. Nephrol Dial Transplant. 2023;38(2):271-82. DOI:10.1093/ndt/gfab268
25. Downie ML, Lopez Garcia SC, Kleta R, Bockenhauer D. Inherited tubulopathies of the kidney: insights from genetics. Clin J Am Soc Nephrol. 2021;16(4):620-30. DOI:10.2215/CJN.14481119
26. Kermond R, Mallett A, McCarthy H. A clinical approach to tubulopathies in children and young adults. Pediatr Nephrol. 2023;38(3):651-62. DOI:10.1007/s00467-022-05606-1
27. Chebotareva NV, Tsygin AN, Bulanov NM, et al. Fanconi syndrome in adults and children. Klinicheskaya Farmakologiya i Terapiya. 2022;31(1):69-74 (in Russian).
DOI:10.32756/ 0869-5490-2022-1-69-74
28. Besouw MTP, Kleta R, Bockenhauer D. Bartter and Gitelman syndromes: questions of class. Pediatr Nephrol. 2020;35:1815-24. DOI:10.1007/s00467-019-04371-y
29. Moiseev SV, Tao EA, Moiseev AS, et al. Clinical manifestations and outcomes of Fabry disease in 150 adult patients. Klinicheskaya Farmakologiya i Terapiya. 2021;30(3):43-51 (in Russian). DOI:10.32756/ 0869-5490-2021-3-43-51
30. Moiseev AS, Bulanov NM, Tao EA, et al. Efficacy and safety of long-term enzyme replacement therapy with agalsidase alfa or agalsidase beta in adult patients with Fabry disease. Klinicheskaya Farmakologiya i Terapiya. 2022;31(4):28-34 (in Russian). DOI:10.32756/0869-5490-2022-4-28-34
31. Chebotareva NV, Tsygin AN, Bulanov NM, et al. Cystinosis: pathogenesis, clinical features and treatment. Klinicheskaya Farmakologiya i Terapiya. 2021;30(1):80-8 (in Russian). DOI:10.32756/ 0869-5490-2021-1-80-88
32. Emma F, van’t Hoff W, Hohenfellner K, et al. An international cohort study spanning five decades assessed outcomes of nephropathic cystinosis. Kidney Int. 2021;100(5):1112-23. DOI:10.1016/j.kint.2021.06.019
33. Shee K, Stoller ML. Perspectives in primary hyperoxaluria – historical, current and future clinical interventions. Nat Rev Urol. 2022;19(3):137-46. DOI:10.1038/s41585-021-00543-4
34. Michael M, Groothoff JW, Shasha-Lavsky H, et al. Lumasiran for advanced primary hyperoxaluria type 1: phase 3 ILLUMINATE-C trial. Am J Kidney Dis. 2023;81(2):145-55. DOI:10.1053/j.ajkd.2022.05.012
35. Rameev VV, Moiseev SV, Kozlovskaya LV. AA amyloidosis in autoinflammatory diseases. Klinicheskaya Farmakologiya i Terapiya. 2021;30(4):52-61 (in Russian).
DOI:10.32756/0869-54902021-4-52-61
36. Moiseev SV, Rameev VV. Differential diagnosis of systemic autoinflammatory diseases. Klinicheskaya Farmakologiya i Terapiya. 2022;31(2):5-13 (in Russian).
DOI:10.32756/ 0869-5490-2022-2-5-13
37. Damy T, Garcia-Pavia P, Hanna M, et al. Efficacy and safety of tafamidis doses in the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) and long-term extension study. Europ J Heart Fail. 2021;23:277-85. DOI:10.1002/ejhf.2027
38. Korotchaeva YuV, Kozlovskaya NL, Demyanova KA, et al. Atypical hemolytic-uremic syndrome: clinical presentation, diagnosis and treatment. Klinicheskaya Farmakologiya i Terapiya. 2022;31(2):43-50 (in Russian). DOI:10.32756/0869-54902022-2-43-50
39. Kozlovskaya NL, Prokopenko EI, Emirova KhM, Serikova SYu. Clinical guidelines for diagnosis and treatment of atypical hemolytic uremic syndrome. Nephrology and Dialysis. 2015;17(3):242-64 (in Russian). DOI:10.32756/0869-5490-2022-2-43-50
40. Granhøj J, Tougaard B, Lildballe DL, Rasmussen M. Family history is important to identify patients with monogenic causes of adult-onset chronic kidney disease. Nephron. 2022;146(1):49-57. DOI:10.1159/000518175
41. Moiseev S, Tao E, Moiseev A, et al. The benefits of family screening in rare diseases: genetic testing reveals 165 new cases of Fabry disease among at-risk family members of 83 index patients. Genes (Basel). 2022;13(9):1619. DOI:10.3390/genes13091619
Авторы
С.В. Моисеев*1,2, Е.М. Шилов1
1ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия; 2ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», Москва, Россия
*avt420034@gmail.com
________________________________________________
Sergey V. Moiseev*1,2, Eugene M. Shilov1
1Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2Lomonosov Moscow State University, Moscow, Russia
*avt420034@gmail.com