Entry - #310468 - NEPHROLITHIASIS, X-LINKED RECESSIVE, WITH RENAL FAILURE; XRN - OMIM
# 310468

NEPHROLITHIASIS, X-LINKED RECESSIVE, WITH RENAL FAILURE; XRN


Alternative titles; symbols

NEPHROLITHIASIS, X-LINKED RECESSIVE, TYPE 1
UROLITHIASIS, X-LINKED RECESSIVE, TYPE 1
NEPHROLITHIASIS 1; NPHL1


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
Xp11.23 Nephrolithiasis, type I 310468 XLR 3 CLCN5 300008
Clinical Synopsis
 

INHERITANCE
- X-linked recessive
GENITOURINARY
Kidneys
- Proximal renal tubule defect
- Nephrocalcinosis
- Nephrolithiasis
- Renal insufficiency, progressive
- Renal failure in adulthood
- Renal biopsy shows tubular atrophy
- Interstitial fibrosis
- Glomerulosclerosis
LABORATORY ABNORMALITIES
- Low-molecular-weight proteinuria
- Hypercalciuria
- Microscopic hematuria
MISCELLANEOUS
- Variable phenotypic severity
- Female carriers may have asymptomatic proteinuria or hypercalciuria
- Part of 'Dent disease complex' (see 300009)
MOLECULAR BASIS
- Caused by mutation in the chloride channel 5 gene (CLCN5, 300008.0005)

TEXT

A number sign (#) is used with this entry because of evidence that X-linked recessive nephrolithiasis with renal failure (XRN) is caused by mutation in the CLCN5 gene (300008) on chromosome Xp11.


Description

X-linked recessive nephrolithiasis with renal failure (XRN) is a form of X-linked hypercalciuric nephrolithiasis, which comprises a group of disorders characterized by proximal renal tubular reabsorptive failure, hypercalciuria, nephrolithiasis, and renal insufficiency. These disorders have also been referred to as the 'Dent disease complex' (Scheinman, 1998; Gambaro et al., 2004). For a general discussion of Dent disease, see 300009.


Clinical Features

Frymoyer et al. (1991) reported a large kindred living in the St. Lawrence valley of northern New York, descendants of 19th century Irish immigrants, with nephrolithiasis inherited in an X-linked recessive pattern. Nine affected males had onset in childhood of calcium nephrolithiasis and proteinuria, with progression to nephrocalcinosis and renal insufficiency. Renal biopsies showed tubular atrophy, interstitial fibrosis, and glomerulosclerosis. Renal biopsies were abnormal even in younger members, but abnormalities in the renal excretion of calcium, phosphate, potassium, and uric acid were found only in affected adults. In 1 patient who had a renal transplant for 7 years, the disease had not recurred. Frymoyer et al. (1992) pointed out that patients with X-linked recessive nephrocalcinosis differed from Dent disease by having normal growth, no evidence of bone disease, and sometimes absence of hypercalciuria despite the presence of nephrocalcinosis, recurrent calcium nephrolithiasis, or both. Furthermore, all could acidify their urine to a pH below 5.6.


Mapping

In the family reported by Frymoyer et al. (1991) as having X-linked recessive nephrolithiasis, Scheinman et al. (1993) found linkage to chromosome Xp11.22 (maximum lod score of 5.91 at marker DXS255). Multilocus analysis indicated that the mutant gene was distal to DXS255 but proximal to the DMD (300377) locus.


Molecular Genetics

In affected members from 2 unrelated North American families with X-linked recessive nephrolithiasis, Lloyd et al. (1996) identified 2 different mutations in the CLCN5 gene (300008.0005; 300008.0006).

In affected members of a kindred with X-linked recessive nephrolithiasis, Schurman et al. (1998) identified a mutation in the CLCN5 gene (300008.0011). The disease had occurred in males in first, third, and fifth generations, with the carrier females in the intervening second and fourth generations. Individuals at risk were screened with renal ultrasonography and measurement of urinary excretion of low molecular weight proteins and calcium.


Nomenclature

Scheinman et al. (1993) suggested the symbol 'XRN' (for X-linked recessive nephrolithiasis) for this disorder; NPHL1 was the locus symbol assigned by the human gene nomenclature committee.


REFERENCES

  1. Frymoyer, P. A., Scheinman, S. J., Dunham, P. B., Jones, D. B., Hueber, P., Schroeder, E. T. X-linked recessive nephrolithiasis with renal failure. New Eng. J. Med. 325: 681-686, 1991. [PubMed: 1908057, related citations] [Full Text]

  2. Frymoyer, P. A., Scheinman, S. J., Schroeder, E. T. X-linked recessive nephrolithiasis with renal failure. (Letter) New Eng. J. Med. 326: 1029-1030, 1992. [PubMed: 1372109, related citations] [Full Text]

  3. Gambaro, G., Vezzoli, G., Casari, G., Rampoldi, L., D'Angelo, A., Borghi, L. Genetics of hypercalciuria and calcium nephrolithiasis: from the rare monogenic to the common polygenic forms. Am. J. Kidney Dis. 44: 963-986, 2004. [PubMed: 15558518, related citations] [Full Text]

  4. Lloyd, S. E., Pearce, S. H. S., Fisher, S. E., Steinmeyer, K., Schwappach, B., Scheinman, S. J., Harding, B., Bolino, A., Devoto, M., Goodyer, P., Rigden, S. P. A., Wrong, O., Jentsch, T. J., Craig, I. W., Thakker, R. V. A common molecular basis for three inherited kidney stone diseases. Nature 379: 445-449, 1996. [PubMed: 8559248, related citations] [Full Text]

  5. Scheinman, S. J., Pook, M. A., Wooding, C., Pang, J. T., Frymoyer, P. A., Thakker, R. V. Mapping the gene causing X-linked recessive nephrolithiasis to Xp11.22 by linkage studies. J. Clin. Invest. 91: 2351-2357, 1993. [PubMed: 8099916, related citations] [Full Text]

  6. Scheinman, S. J. X-linked hypercalciuric nephrolithiasis: clinical syndromes and chloride channel mutations. Kidney Int. 53: 3-17, 1998. [PubMed: 9452994, related citations] [Full Text]

  7. Schurman, S. J., Norden, A. G. W., Scheinman, S. J. X-linked recessive nephrolithiasis: presentation and diagnosis in children. J. Pediat. 132: 859-862, 1998. [PubMed: 9602200, related citations] [Full Text]


Cassandra L. Kniffin - reorganized : 9/19/2005
Victor A. McKusick - updated : 6/10/1998
Creation Date:
Victor A. McKusick : 9/18/1991
carol : 06/22/2021
terry : 11/25/2009
ckniffin : 9/15/2008
carol : 9/19/2005
ckniffin : 9/6/2005
terry : 6/15/1998
dholmes : 6/10/1998
dholmes : 6/10/1998
joanna : 2/1/1996
mark : 1/31/1996
mark : 1/31/1996
terry : 1/30/1996
terry : 12/21/1994
warfield : 4/20/1994
mimadm : 3/1/1994
carol : 2/28/1994
carol : 7/9/1993
carol : 10/13/1992

# 310468

NEPHROLITHIASIS, X-LINKED RECESSIVE, WITH RENAL FAILURE; XRN


Alternative titles; symbols

NEPHROLITHIASIS, X-LINKED RECESSIVE, TYPE 1
UROLITHIASIS, X-LINKED RECESSIVE, TYPE 1
NEPHROLITHIASIS 1; NPHL1


SNOMEDCT: 236713006;   ORPHA: 1652, 93622;   DO: 0111798;  


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
Xp11.23 Nephrolithiasis, type I 310468 X-linked recessive 3 CLCN5 300008

TEXT

A number sign (#) is used with this entry because of evidence that X-linked recessive nephrolithiasis with renal failure (XRN) is caused by mutation in the CLCN5 gene (300008) on chromosome Xp11.


Description

X-linked recessive nephrolithiasis with renal failure (XRN) is a form of X-linked hypercalciuric nephrolithiasis, which comprises a group of disorders characterized by proximal renal tubular reabsorptive failure, hypercalciuria, nephrolithiasis, and renal insufficiency. These disorders have also been referred to as the 'Dent disease complex' (Scheinman, 1998; Gambaro et al., 2004). For a general discussion of Dent disease, see 300009.


Clinical Features

Frymoyer et al. (1991) reported a large kindred living in the St. Lawrence valley of northern New York, descendants of 19th century Irish immigrants, with nephrolithiasis inherited in an X-linked recessive pattern. Nine affected males had onset in childhood of calcium nephrolithiasis and proteinuria, with progression to nephrocalcinosis and renal insufficiency. Renal biopsies showed tubular atrophy, interstitial fibrosis, and glomerulosclerosis. Renal biopsies were abnormal even in younger members, but abnormalities in the renal excretion of calcium, phosphate, potassium, and uric acid were found only in affected adults. In 1 patient who had a renal transplant for 7 years, the disease had not recurred. Frymoyer et al. (1992) pointed out that patients with X-linked recessive nephrocalcinosis differed from Dent disease by having normal growth, no evidence of bone disease, and sometimes absence of hypercalciuria despite the presence of nephrocalcinosis, recurrent calcium nephrolithiasis, or both. Furthermore, all could acidify their urine to a pH below 5.6.


Mapping

In the family reported by Frymoyer et al. (1991) as having X-linked recessive nephrolithiasis, Scheinman et al. (1993) found linkage to chromosome Xp11.22 (maximum lod score of 5.91 at marker DXS255). Multilocus analysis indicated that the mutant gene was distal to DXS255 but proximal to the DMD (300377) locus.


Molecular Genetics

In affected members from 2 unrelated North American families with X-linked recessive nephrolithiasis, Lloyd et al. (1996) identified 2 different mutations in the CLCN5 gene (300008.0005; 300008.0006).

In affected members of a kindred with X-linked recessive nephrolithiasis, Schurman et al. (1998) identified a mutation in the CLCN5 gene (300008.0011). The disease had occurred in males in first, third, and fifth generations, with the carrier females in the intervening second and fourth generations. Individuals at risk were screened with renal ultrasonography and measurement of urinary excretion of low molecular weight proteins and calcium.


Nomenclature

Scheinman et al. (1993) suggested the symbol 'XRN' (for X-linked recessive nephrolithiasis) for this disorder; NPHL1 was the locus symbol assigned by the human gene nomenclature committee.


REFERENCES

  1. Frymoyer, P. A., Scheinman, S. J., Dunham, P. B., Jones, D. B., Hueber, P., Schroeder, E. T. X-linked recessive nephrolithiasis with renal failure. New Eng. J. Med. 325: 681-686, 1991. [PubMed: 1908057] [Full Text: https://doi.org/10.1056/NEJM199109053251003]

  2. Frymoyer, P. A., Scheinman, S. J., Schroeder, E. T. X-linked recessive nephrolithiasis with renal failure. (Letter) New Eng. J. Med. 326: 1029-1030, 1992. [PubMed: 1372109] [Full Text: https://doi.org/10.1056/NEJM199204093261516]

  3. Gambaro, G., Vezzoli, G., Casari, G., Rampoldi, L., D'Angelo, A., Borghi, L. Genetics of hypercalciuria and calcium nephrolithiasis: from the rare monogenic to the common polygenic forms. Am. J. Kidney Dis. 44: 963-986, 2004. [PubMed: 15558518] [Full Text: https://doi.org/10.1053/j.ajkd.2004.06.030]

  4. Lloyd, S. E., Pearce, S. H. S., Fisher, S. E., Steinmeyer, K., Schwappach, B., Scheinman, S. J., Harding, B., Bolino, A., Devoto, M., Goodyer, P., Rigden, S. P. A., Wrong, O., Jentsch, T. J., Craig, I. W., Thakker, R. V. A common molecular basis for three inherited kidney stone diseases. Nature 379: 445-449, 1996. [PubMed: 8559248] [Full Text: https://doi.org/10.1038/379445a0]

  5. Scheinman, S. J., Pook, M. A., Wooding, C., Pang, J. T., Frymoyer, P. A., Thakker, R. V. Mapping the gene causing X-linked recessive nephrolithiasis to Xp11.22 by linkage studies. J. Clin. Invest. 91: 2351-2357, 1993. [PubMed: 8099916] [Full Text: https://doi.org/10.1172/JCI116467]

  6. Scheinman, S. J. X-linked hypercalciuric nephrolithiasis: clinical syndromes and chloride channel mutations. Kidney Int. 53: 3-17, 1998. [PubMed: 9452994] [Full Text: https://doi.org/10.1046/j.1523-1755.1998.00718.x]

  7. Schurman, S. J., Norden, A. G. W., Scheinman, S. J. X-linked recessive nephrolithiasis: presentation and diagnosis in children. J. Pediat. 132: 859-862, 1998. [PubMed: 9602200] [Full Text: https://doi.org/10.1016/s0022-3476(98)70318-x]


Contributors:
Cassandra L. Kniffin - reorganized : 9/19/2005
Victor A. McKusick - updated : 6/10/1998

Creation Date:
Victor A. McKusick : 9/18/1991

Edit History:
carol : 06/22/2021
terry : 11/25/2009
ckniffin : 9/15/2008
carol : 9/19/2005
ckniffin : 9/6/2005
terry : 6/15/1998
dholmes : 6/10/1998
dholmes : 6/10/1998
joanna : 2/1/1996
mark : 1/31/1996
mark : 1/31/1996
terry : 1/30/1996
terry : 12/21/1994
warfield : 4/20/1994
mimadm : 3/1/1994
carol : 2/28/1994
carol : 7/9/1993
carol : 10/13/1992