title: Whole-exome sequencing for prenatal diagnosis of fetuses with congenital anomalies of the kidney and urinary tract.
abstract: BACKGROUND
  In the absence of cytogenetic abnormality, fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) with/without other structural anomalies show a higher likelihood of monogenic causes; however, defining the underlying pathology can be challenging. Here, we investigate the value of whole-exome sequencing (WES) in fetuses with CAKUT but normal findings upon karyotyping and chromosome microarray analysis.
  
  
  METHODS
  WES was performed on DNA from the cord blood of 30 fetuses with unexplained CAKUT with/without other structural anomalies. In the first 23 cases, sequencing was initially performed on fetal DNA only; for the remaining seven cases, the trio of fetus, mother and father was sequenced simultaneously.
  
  
  RESULTS
  Of the 30 cases, pathogenic variants were identified in 4 (13%) (UMOD, NEK8, HNF1B and BBS2) and incidental variants in 2 (7%) (HSPD1 and GRIN2B). Furthermore, two of the above four cases had other anomalies in addition to CAKUT. Thus, the detection rate was only 2/22 (9.1%) for isolated CAKUT and 2/8 (25%) for CAKUT with other abnormalities.
  
  
  CONCLUSIONS
  Applying WES to the prenatal diagnostic approach in CAKUT fetuses with or without other anomalies allows for an accurate and early etiology-based diagnosis and improved clinical management. To expedite interpretation of the results, trio sequencing should be employed; however, interpretation may nevertheless be compromised by incomplete coverage of all relevant genes.
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Ting-Ying
authors.initials: TY
authors.lastname: Lei
authors.affiliation: Eugenic and Perinatal Institute, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Fu
authors.affiliation: Eugenic and Perinatal Institute, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Ru
authors.initials: R
authors.lastname: Li
authors.affiliation: Eugenic and Perinatal Institute, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Rong-Yue
authors.initials: RY
authors.lastname: Wang
authors.affiliation: Eugenic and Perinatal Institute, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Xiang-Yi
authors.initials: XY
authors.lastname: Jing
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Deng
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Zhou-Zhou
authors.initials: ZZ
authors.lastname: Li
authors.affiliation: Eugenic and Perinatal Institute, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Ze-Qun
authors.initials: ZQ
authors.lastname: Liu
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yang
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Dong-Zhi
authors.initials: DZ
authors.lastname: Li
authors.affiliation: Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
authors.forename: Can
authors.initials: C
authors.lastname: Liao
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D000649:Amniocentesis; D001483:Base Sequence; D004252:DNA Mutational Analysis; D059472:Exome; D005260:Female; D005333:Fetus; D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D025202:Molecular Diagnostic Techniques; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014551:Urinary Tract / Q000002:abnormalities / Q000000981:diagnostic imaging; D014564:Urogenital Abnormalities / Q000000981:diagnostic imaging / Q000235:genetics*; D000073359:Exome Sequencing; D055815:Young Adult
keywords: BBS2; NEK8; UMOD; congenital anomalies of the kidney and urinary tract; monogenic causes