Proteinuria and prenatal diagnosis of congenital nephrosis in fetal carriers of nephrin gene mutations.
High concentrations of alpha-fetoprotein (AFP) are used for prenatal diagnosis of the Finnish type of congenital nephrotic syndrome (NPHS1). We investigated the validity of this test. We retrospectively established fetal NPHS1 genotype and assessed renal pathology in 21 pregnancies that had been terminated because of raised concentrations of AFP in amniotic fluid. 12 fetuses were homozygous and nine were heterozygous (carriers) for NPHS1 mutations. Raised concentrations of AFP and similar proteinuric features in fetal kidneys were seen in both groups, indicating that these signs are unreliable for prenatal diagnosis of congenital nephrosis. We strongly recommend the use of mutation analysis of the NPHS1 gene to confirm the AFP results in prenatal diagnosis of NPHS1.
Patrakka
Jaakko
J
Hospital for Children and Adolescents and Biomedicum Helsinki, Electron Microscopy Unit, Institute of Biotechnology, University of Helsinki, Helsinki, Finland.
Martin
Paula
P
Salonen
Riitta
R
Kestilä
Marjo
M
Ruotsalainen
Vesa
V
Männikkö
Minna
M
Ryynänen
Markku
M
Rapola
Juhani
J
Holmberg
Christer
C
Tryggvason
Karl
K
Jalanko
Hannu
H
D000483:Alleles; D000653:Amniotic Fluid / Q000737:chemistry; D005260:Female; D005387:Finland; D005838:Genotype; D006801:Humans; D008565:Membrane Proteins; D009154:Mutation; D009401:Nephrosis / Q000151:congenital / Q000175:diagnosis / Q000235:genetics*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011506:Proteins / Q000235:genetics* / Q000378:metabolism; D011507:Proteinuria / Q000151:congenital* / Q000175:diagnosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D000509:alpha-Fetoproteins / Q000032:analysis*
D008565:Membrane Proteins; D011506:Proteins; D000509:alpha-Fetoproteins; C113267:nephrin