Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2024, Vol. 33 ›› Issue (6): 501-507.DOI: 10.3969/j.issn.1006-298X.2024.06.001
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Abstract: Objective: To investigate the gene mutation characteristics and clinicopathological manifestations of patients with TRPC6 gene mutation. Methodology: We screened our patients with TRPC6 gene mutation confirmed by whole exon or nephropathy panel gene detection in the National Clinical Research Center for kidney Disease, and then analyzed the gene mutation characteristics, clinicopathology and prognosis of the patients. Results:A total of 10 patients were included in the study, of which 50% were male and 50% were female. 8 heterozygous mutations of TRPC6 gene were detected in the 10 patients, of which 6 were missense mutations, and c.2683C>T(p.R895C) was the most common. There were 9 cases with positive family history of kidney disease. The onset age of the patients was 16- 35 years old, and all of them were onset with proteinuria, even 4 cases showed nephrotic syndrome (NS). All patients were treated with angiotensin II receptor blockers (ARB), of which 5 patients were treated with hormone combined with calcineurin inhibitors (CNI), and 2 patients were treated with moderate hormone. 6 patients progressed to end⁃stage kidney disease (ESKD) in the course of 1 - 17 years. The pathological manifestations of renal biopsy in 6 patients were focal segmental glomerulosclerosis (FSGS), with 4 cases of foot process extensive fusion (50%-80%) and 2 cases of segmental fusion (30%-50%), and no glomerular basement membrane lesions. Conclusion:The mutation of TRPC6 gene is mainly missense mutation, and the most common mutation site is c.2683C> T (p.R895C). The clinical manifestations of patients with related nephropathy are mainly proteinuria, most of which are NS. Renal pathology was mainly FSGS, and podocyte foot process fusion was obvious. Most patients have poor efficacy on ARB and CNIs, and eventually progress to ESKD. The early diagnosis and timely specific intervention of the disease may be the key to improve the prognosis of patients.
Key words: TRPC6 gene mutation  , proteinuria  , focal segmental glomerulosclerosis  , end?stage kidney disease
ZHONG Qing, ZHANG Changming, ZHU Li, WANG Gang, ZHANG Lihua, LIU Zhihong. Genotypic and clinical features in patients with TRPC6 gene mutations[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2024, 33(6): 501-507.
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URL: http://www.njcndt.com/EN/10.3969/j.issn.1006-298X.2024.06.001
http://www.njcndt.com/EN/Y2024/V33/I6/501