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논문 기본 정보

자료유형
학술저널
저자정보
Kim Ji Hyun (Department of Pediatrics Seoul National University Bundang Hospital Seongnam Korea.Department of Pe)
저널정보
대한소아신장학회 Childhood Kidney Diseases Childhood Kidney Diseases 제26권 제1호
발행연도
2022.6
수록면
31 - 39 (9page)
DOI
10.3339/ckd.22.022

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초록· 키워드

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Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked (XLAS), autosomal recessive (ARAS), and autosomal dominant (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female “carriers” to “patients” and “thin basement membrane nephropathy” to “ADAS.” In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

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