Skip to main content

Abstract

Polycystic kidney disease (PKD) is a group of monogenic disorders that result in renal cyst development, progressive chronic kidney disease, and are associated with extrarenal manifestations. The most common form, autosomal dominant PKD (ADPKD), is a multisystem disease most often diagnosed in adults and caused by mutations in PKD1 and PKD2. The PKD1 gene product, polycystin-1 (PC1), is a large receptor like protein. The PKD2 gene product, polycystin-2 (PC2)’ is a member of the transient receptor potential family (i.e., TRPP2) and is a nonselective cation channel that is permeable to calcium. Both PC1 and PC2 are located on non-motile cilia located on virtually all epithelia and other cell types.

Autosomal recessive PKD (ARPKD) usually presents during infancy with enlarged kidneys and hepatic fibrosis, but patients are increasingly being identified during childhood and early adulthood. ARPKD is caused by mutations in PKHD1. The protein encoded by this gene, polyductin, is localized to the basal body of non-motile cilia and can form a complex with PC2.

Molecular genetic testing plays an increasingly important role in the management of PKD. In ADPKD, testing enables early diagnosis of patients with inconclusive results by kidney imaging; this can clarify the disease status of a prospective related kidney donor. In both ADPKD and ARPKD, testing can inform pre-implantation genetic diagnosis (PGD). The purpose of this chapter is to review the clinical and laboratory characteristics of these disorders and to describe the application of emerging molecular technologies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Peters DJ, Sandkuijl LA. Genetic heterogeneity of polycystic kidney disease in Europe. Contrib Nephrol. 1992;97:128–39.

    Article  CAS  PubMed  Google Scholar 

  2. Rossetti S, Burton S, Strmecki L, et al. The position of the polycystic kidney disease 1 (PKD1) gene mutation correlates with the severity of renal disease. J Am Soc Nephrol. 2002;13(5):1230–7.

    Article  CAS  PubMed  Google Scholar 

  3. Kelleher CL, McFann KK, Johnson AM, et al. Characteristics of hypertension in young adults with autosomal dominant polycystic kidney disease compared with the general U.S. population. Am J Hypertens. 2004;17(11, Pt 1):1029–34.

    Article  PubMed  Google Scholar 

  4. Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet. 2007;369(9569):1287–301.

    Article  PubMed  Google Scholar 

  5. Braun WE. Autosomal dominant polycystic kidney disease: emerging concepts of pathogenesis and new treatments. Cleve Clin J Med. 2009;76(2):97–104.

    Article  PubMed  Google Scholar 

  6. Harris PC. 2008 Homer W. Smith Award: insights into the pathogenesis of polycystic kidney disease from gene discovery. J Am Soc Nephrol. 2009;20(6):1188–98.

    Article  CAS  PubMed  Google Scholar 

  7. Fliegauf M, Benzing T, Omran H. When cilia go bad: cilia defects and ciliopathies. Nat Rev Mol Cell Biol. 2007;8(11):880–93.

    Article  CAS  PubMed  Google Scholar 

  8. Sedman A, Bell P, Manco-Johnson M, et al. Autosomal dominant polycystic kidney disease in childhood: a longitudinal study. Kidney Int. 1987;31(4):1000–5.

    Article  CAS  PubMed  Google Scholar 

  9. Sweeney Jr WE, Avner ED. Diagnosis and management of childhood polycystic kidney disease. Pediatr Nephrol. 2011;26(5):675–92.

    Article  PubMed  Google Scholar 

  10. Hughes J, Ward CJ, Peral B, et al. The polycystic kidney disease 1 (PKD1) gene encodes a novel protein with multiple cell recognition domains. Nat Genet. 1995;10(2):151–60.

    Article  CAS  PubMed  Google Scholar 

  11. Mochizuki T, Wu G, Hayashi T, et al. PKD2, a gene for polycystic kidney disease that encodes an integral membrane protein. Science. 1996;272(5266):1339–42.

    Article  CAS  PubMed  Google Scholar 

  12. Harris PC, Rossetti S. Molecular diagnostics for autosomal dominant polycystic kidney disease. Nat Rev Nephrol. 2010;6(4):197–206.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Consortium TIPKD. Polycystic kidney disease: the complete structure of the PKD1 gene and its protein. The International Polycystic Kidney Disease Consortium. Cell. 1995;81(2):289–98.

    Article  Google Scholar 

  14. Reed B, McFann K, Kimberling WJ, et al. Presence of de novo mutations in autosomal dominant polycystic kidney disease patients without family history. Am J Kidney Dis. 2008;52(6):1042–50.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Torres VE, Harris PC. Autosomal dominant polycystic kidney disease: the last 3 years. Kidney Int. 2009;76(2):149–68.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Sandford R, Sgotto B, Aparicio S, et al. Comparative analysis of the polycystic kidney disease 1 (PKD1) gene reveals an integral membrane glycoprotein with multiple evolutionary conserved domains. Hum Mol Genet. 1997;6(9):1483–9.

    Article  CAS  PubMed  Google Scholar 

  17. Hanaoka K, Qian F, Boletta A, et al. Co-assembly of polycystin-1 and -2 produces unique cation-permeable currents. Nature. 2000;408(6815):990–4.

    Article  CAS  PubMed  Google Scholar 

  18. Yoder BK, Tousson A, Millican L, et al. Polaris, a protein disrupted in orpk mutant mice, is required for assembly of renal cilium. Am J Physiol Renal Physiol. 2002;282(3):F541–52.

    Article  CAS  PubMed  Google Scholar 

  19. Qian F, Germino FJ, Cai Y, et al. PKD1 interacts with PKD2 through a probable coiled-coil domain. Nat Genet. 1997;16(2):179–83.

    Article  CAS  PubMed  Google Scholar 

  20. Nauli SM, Alenghat FJ, Luo Y, et al. Polycystins 1 and 2 mediate mechanosensation in the primary cilium of kidney cells. Nat Genet. 2003;33(2):129–37.

    Article  CAS  PubMed  Google Scholar 

  21. Yamaguchi T, Wallace DP, Magenheimer BS, et al. Calcium restriction allows cAMP activation of the B-Raf/ERK pathway, switching cells to a cAMP-dependent growth-stimulated phenotype. J Biol Chem. 2004;279(39):40419–30.

    Article  CAS  PubMed  Google Scholar 

  22. Wu G, Tian X, Nishimura S, et al. Trans-heterozygous Pkd1 and Pkd2 mutations modify expression of polycystic kidney disease. Hum Mol Genet. 2002;11(16):1845–54.

    Article  CAS  PubMed  Google Scholar 

  23. Arnaout MA. Molecular genetics and pathogenesis of autosomal dominant polycystic kidney disease. Annu Rev Med. 2001;52:93–123.

    Article  CAS  PubMed  Google Scholar 

  24. Pei Y. A “two-hit” model of cystogenesis in autosomal dominant polycystic kidney disease? Trends Mol Med. 2001;7(4):151–6.

    Article  CAS  PubMed  Google Scholar 

  25. Pei Y, Paterson AD, Wang KR, et al. Bilineal disease and trans-heterozygotes in autosomal dominant polycystic kidney disease. Am J Hum Genet. 2001;68(2):355–63.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Hopp K, Ward CJ, Hommerding CJ, et al. Functional polycystin-1 dosage governs autosomal dominant polycystic kidney disease severity. J Clin Invest. 2012;122(11):4257–73.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Koptides M, Mean R, Demetriou K, et al. Genetic evidence for a trans-heterozygous model for cystogenesis in autosomal dominant polycystic kidney disease. Hum Mol Genet. 2000;9(3):447–52.

    Article  CAS  PubMed  Google Scholar 

  28. Chapin HC, Caplan MJ. The cell biology of polycystic kidney disease. J Cell Biol. 2010;191(4):701–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Torres VE, Harris PC. Polycystic kidney disease in 2011: connecting the dots toward a polycystic kidney disease therapy. Nat Rev Nephrol. 2011;8(2):66–8.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Hateboer N, v Dijk MA, Bogdanova N, et al. Comparison of phenotypes of polycystic kidney disease types 1 and 2. European PKD1-PKD2 Study Group. Lancet. 1999;353(9147):103–7.

    Article  CAS  PubMed  Google Scholar 

  31. Harris PC, Bae KT, Rossetti S, et al. Cyst number but not the rate of cystic growth is associated with the mutated gene in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 2006;17(11):3013–9.

    Article  CAS  PubMed  Google Scholar 

  32. Rossetti S, Chauveau D, Walker D, et al. A complete mutation screen of the ADPKD genes by DHPLC. Kidney Int. 2002;61(5):1588–99.

    Article  CAS  PubMed  Google Scholar 

  33. Rossetti S, Chauveau D, Kubly V, et al. Association of mutation position in polycystic kidney disease 1 (PKD1) gene and development of a vascular phenotype. Lancet. 2003;361(9376):2196–201.

    Article  CAS  PubMed  Google Scholar 

  34. Cornec-Le Gall E, Audrezet MP, Chen JM, et al. Type of PKD1 mutation influences renal outcome in ADPKD. J Am Soc Nephrol. 2013;24(6):1006–13.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Rossetti S, Kubly VJ, Consugar MB, et al. Incompletely penetrant PKD1 alleles suggest a role for gene dosage in cyst initiation in polycystic kidney disease. Kidney Int. 2009;75(8):848–55.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Geberth S, Ritz E, Zeier M, et al. Anticipation of age at renal death in autosomal dominant polycystic kidney disease (ADPKD)? Nephrol Dial Transplant. 1995;10(9):1603–6.

    CAS  PubMed  Google Scholar 

  37. Peral B, Gamble V, San Millan JL, et al. Splicing mutations of the polycystic kidney disease 1 (PKD1) gene induced by intronic deletion. Hum Mol Genet. 1995;4(4):569–74.

    Article  CAS  PubMed  Google Scholar 

  38. Persu A, Duyme M, Pirson Y, et al. Comparison between siblings and twins supports a role for modifier genes in ADPKD. Kidney Int. 2004;66(6):2132–6.

    Article  CAS  PubMed  Google Scholar 

  39. Fain PR, McFann KK, Taylor MR, et al. Modifier genes play a significant role in the phenotypic expression of PKD1. Kidney Int. 2005;67(4):1256–67.

    Article  CAS  PubMed  Google Scholar 

  40. Liu M, Shi S, Senthilnathan S, et al. Genetic variation of DKK3 may modify renal disease severity in ADPKD. J Am Soc Nephrol. 2010;21(9):1510–20.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Rossetti S, Harris PC. Genotype-phenotype correlations in autosomal dominant and autosomal recessive polycystic kidney disease. J Am Soc Nephrol. 2007;18(5):1374–80.

    Article  CAS  PubMed  Google Scholar 

  42. Ravine D, Gibson RN, Walker RG, et al. Evaluation of ultrasonographic diagnostic criteria for autosomal dominant polycystic kidney disease 1. Lancet. 1994;343(8901):824–7.

    Article  CAS  PubMed  Google Scholar 

  43. Pei Y, Obaji J, Dupuis A, et al. Unified criteria for ultrasonographic diagnosis of ADPKD. J Am Soc Nephrol. 2009;20(1):205–12.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  44. Pei Y, Hwang YH, Conklin J, et al. Imaging-based diagnosis of autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 2015;26(3):746–53.

    Article  CAS  PubMed  Google Scholar 

  45. Huang E, Samaniego-Picota M, McCune T, et al. DNA testing for live kidney donors at risk for autosomal dominant polycystic kidney disease. Transplantation. 2009;87(1):133–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  46. Blumenfeld JD. Pretransplant genetic testing of live kidney donors at risk for autosomal dominant polycystic kidney disease. Transplantation. 2009;87(1):6–7.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Rossetti S, Strmecki L, Gamble V, et al. Mutation analysis of the entire PKD1 gene: genetic and diagnostic implications. Am J Hum Genet. 2001;68(1):46–63.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. Garcia-Gonzalez MA, Jones JG, Allen SK, et al. Evaluating the clinical utility of a molecular genetic test for polycystic kidney disease. Mol Genet Metab. 2007;92(1–2):160–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Perrichot R, Mercier B, Quere I, et al. Novel mutations in the duplicated region of PKD1 gene. Eur J Hum Genet. 2000;8(5):353–9.

    Article  CAS  PubMed  Google Scholar 

  50. Tan YC, Blumenfeld JD, Anghel R, et al. Novel method for genomic analysis of PKD1 and PKD2 mutations in autosomal dominant polycystic kidney disease. Hum Mutat. 2009;30(2):264–73.

    Article  CAS  PubMed  Google Scholar 

  51. Tan YC, Blumenfeld J, Michaeel A, et al. Development of a novel, and rapid genetic test for autosomal dominant polycystic kidney disease (ADPKD) genes, PKD1 and PKD2 using long-range PCR. J Mol Diagn. 2012;14:305–13.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  52. Rossetti S, Hopp K, Sikkink RA, et al. Identification of gene mutations in autosomal dominant polycystic kidney disease through targeted resequencing. J Am Soc Nephrol. 2012;23(5):915–33.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  53. Tan YC, Michaeel A, Liu G, et al. Molecular diagnosis of autosomal dominant polycystic kidney disease using next generation sequencing. J Mol Diagn. 2014;16(2):216–28.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  54. Consugar MB, Wong WC, Lundquist PA, et al. Characterization of large rearrangements in autosomal dominant polycystic kidney disease and the PKD1/TSC2 contiguous gene syndrome. Kidney Int. 2008;74(11):1468–79.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  55. Pei Y. Diagnostic approach in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2006;1(5):1108–14.

    Article  PubMed  Google Scholar 

  56. De Rycke M, Georgiou I, Sermon K, et al. PGD for autosomal dominant polycystic kidney disease type 1. Mol Hum Reprod. 2005;11(1):65–71.

    Article  PubMed  Google Scholar 

  57. Gout AM, Martin NC, Brown AF, et al. PKDB: Polycystic Kidney Disease Mutation Database—a gene variant database for autosomal dominant polycystic kidney disease. Hum Mutat. 2007;28(7):654–9.

    Article  CAS  PubMed  Google Scholar 

  58. Rossetti S, Consugar MB, Chapman AB, et al. Comprehensive molecular diagnostics in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 2007;18(7):2143–60.

    Article  CAS  PubMed  Google Scholar 

  59. Tavtigian SV, Deffenbaugh AM, Yin L, et al. Comprehensive statistical study of 452 BRCA1 missense substitutions with classification of eight recurrent substitutions as neutral. J Med Genet. 2006;43(4):295–305.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Ng PC, Henikoff S. Predicting deleterious amino acid substitutions. Genome Res. 2001;11(5):863–74.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  61. Sunyaev S, Ramensky V, Koch I, et al. Prediction of deleterious human alleles. Hum Mol Genet. 2001;10(6):591–7.

    Article  CAS  PubMed  Google Scholar 

  62. Reese MG, Eeckman FH, Kulp D, et al. Improved splice site detection in Genie. J Comput Biol. 1997;4(3):311–23.

    Article  CAS  PubMed  Google Scholar 

  63. Cartegni L, Wang J, Zhu Z, et al. ESEfinder: a web resource to identify exonic splicing enhancers. Nucleic Acids Res. 2003;31(13):3568–71.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  64. Desmet FO, Hamroun D, Lalande M, et al. Human Splicing Finder: an online bioinformatics tool to predict splicing signals. Nucleic Acids Res. 2009;37(9), e67.

    Article  PubMed Central  PubMed  Google Scholar 

  65. King K, Flinter FA, Nihalani V, et al. Unusual deep intronic mutations in the COL4A5 gene cause X linked Alport syndrome. Hum Genet. 2002;111(6):548–54.

    Article  CAS  PubMed  Google Scholar 

  66. Paul BM, Consugar MB, Ryan-Lee M, et al. Evidence of a third ADPKD locus is not supported by reanalysis of designated PKD3 families. Kidney Int. 2014;85(2):383–92.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  67. Tan YC, Blumenfeld J, Donahue S, et al. Autosomal dominant polycystic kidney disease due to somatic and germline mosaicism. Clin Genet. 2014: April 26. doi:10.1111/cge.12383 [Epub ahead of print].

  68. Lu W, Peissel B, Babakhanlou H, et al. Perinatal lethality with kidney and pancreas defects in mice with a targeted Pkd1 mutation. Nat Genet. 1997;17(2):179–81.

    Article  CAS  PubMed  Google Scholar 

  69. Guay-Woodford LM, Muecher G, Hopkins SD, et al. The severe perinatal form of autosomal recessive polycystic kidney disease maps to chromosome 6p21.1-p12: implications for genetic counseling. Am J Hum Genet. 1995;56(5):1101–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  70. Ward CJ, Hogan MC, Rossetti S, et al. The gene mutated in autosomal recessive polycystic kidney disease encodes a large, receptor-like protein. Nat Genet. 2002;30(3):259–69.

    Article  PubMed  Google Scholar 

  71. Wang S, Zhang J, Nauli SM, et al. Fibrocystin/polyductin, found in the same protein complex with polycystin-2, regulates calcium responses in kidney epithelia. Mol Cell Biol. 2007;27(8):3241–52.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  72. Bergmann C, Senderek J, Sedlacek B, et al. Spectrum of mutations in the gene for autosomal recessive polycystic kidney disease (ARPKD/PKHD1). J Am Soc Nephrol. 2003;14(1):76–89.

    Article  CAS  PubMed  Google Scholar 

  73. Bergmann C, Senderek J, Schneider F, et al. PKHD1 mutations in families requesting prenatal diagnosis for autosomal recessive polycystic kidney disease (ARPKD). Hum Mutat. 2004;23(5):487–95.

    Article  CAS  PubMed  Google Scholar 

  74. Losekoot M, Haarloo C, Ruivenkamp C, et al. Analysis of missense variants in the PKHD1-gene in patients with autosomal recessive polycystic kidney disease (ARPKD). Hum Genet. 2005;118(2):185–206.

    Article  CAS  PubMed  Google Scholar 

  75. Bergmann C, Kupper F, Dornia C, et al. Algorithm for efficient PKHD1 mutation screening in autosomal recessive polycystic kidney disease (ARPKD). Hum Mutat. 2005;25(3):225–31.

    Article  CAS  PubMed  Google Scholar 

  76. Bergmann C, Senderek J, Windelen E, et al. Clinical consequences of PKHD1 mutations in 164 patients with autosomal-recessive polycystic kidney disease (ARPKD). Kidney Int. 2005;67(3):829–48.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hanna Rennert Ph.D., F.A.C.M.G. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Tan, A.Y., Blumenfeld, J., Rennert, H. (2016). Polycystic Kidney Disease. In: Leonard, D. (eds) Molecular Pathology in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-19674-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19674-9_19

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19673-2

  • Online ISBN: 978-3-319-19674-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics