Will kidney disease be passed on to children? The truth is...

Young expectant mothers and fathers with kidney disease often worry that their kidney disease will be passed on to their unborn babies. In fact, for most kidney disease patients, this worry is unnecessary. Although some kidney diseases have a "familial clustering tendency", most kidney diseases are not inherited, and only a small part of kidney diseases will be passed on to the next generation. The following introduces several common kidney diseases with a clear genetic tendency.

Polycystic kidney disease

Polycystic kidney disease is a common hereditary disease. According to different inheritance patterns, polycystic kidney disease is divided into autosomal dominant polycystic kidney disease and autosomal recessive polycystic kidney disease. The latter usually occurs in infancy and is clinically rare.

Autosomal dominant polycystic kidney disease is relatively common and is an important hereditary disease. According to its inheritance rules, the disease will occur from generation to generation in the family, and the probability of occurrence is equal for men and women. If one of the parents suffers from polycystic kidney disease, then both the son and the daughter will have a 50% chance of inheriting polycystic kidney disease. After adolescence and middle age, the patient's kidneys will have numerous cysts of various sizes, ranging in diameter from a few millimeters to a few centimeters. As the age increases, the number of cysts increases, and the cyst cavity expands. Most patients will experience symptoms such as back or rib pain between the ages of 30 and 50. Some patients will have intracystic bleeding or gross hematuria during the course of the disease. Hypertension is also one of the common early manifestations of autosomal dominant polycystic kidney disease. Renal failure usually occurs after middle age, and half of the patients over the age of 60 develop end-stage renal failure and require dialysis treatment.

Alport syndrome

Alport syndrome, also known as hereditary nephritis and familial hemorrhagic nephritis, is characterized by hematuria and chronic progressive renal failure. Some patients also have sensorineural deafness and eye diseases. It is a hereditary familial disease.

In terms of inheritance, X-linked dominant inheritance accounts for about 80%, and the disease-causing gene is on the X chromosome. Inheritance is closely related to gender: males develop the disease earlier and the condition is more severe; females generally develop the disease later and the condition is milder. A typical case is ear-eye-kidney triad, and there are similar patients in the family. The disease mainly has the following manifestations:

0 1 Renal manifestations

The condition in males is significantly more serious than that in females. The earliest and most common manifestation is persistent or recurrent hematuria, which often occurs in males before the age of 5, and some even have hematuria within a few days after birth. About 2/3 may have paroxysmal gross hematuria. Proteinuria gradually appears with age, and some patients have a large amount of urine protein. About 40% of patients show nephrotic syndrome, that is, large amounts of proteinuria, hypoproteinemia, edema and hyperlipidemia. In the later stages of the disease, hypertension and progressive renal function decline often occur. The incidence of uremia is 20%, and the vast majority of patients are male, mostly between the ages of 15 and 30. The incidence of uremia in female patients is lower and occurs later, mostly after the age of 50.

0 2 Extrarenal manifestations

23%~75% of patients with Alport syndrome have sensorineural hearing loss, which manifests as hearing loss. The probability of deafness in men is higher than that in women, and the age of onset is also earlier than that in women. People with sensorineural hearing loss have more severe kidney lesions and develop faster. Deafness may precede kidney damage and abnormal urine tests, or may occur at the same time as kidney damage. The characteristic eye lesions of this disease include anterior lenticule, punctate and macular retinal lesions around the macula of the fundus, etc., with an incidence rate of 15%~40%. Anterior lenticule manifests as progressive myopia (degenerative myopia), which usually occurs at the age of 20~30. Specific retinal lesions usually do not affect vision, and can be detected by ophthalmoscopy or retinal photography. The lesions will progress with the decline of renal function.

Thin basement membrane nephropathy

Thin basement membrane nephropathy is also known as benign familial hematuria. Most patients are asymptomatic and are usually found during examinations or physical examinations for other purposes. This is a common familial genetic disease. It has been reported that this disease accounts for 26% to 51% of patients with persistent microscopic hematuria. Recurrent hematuria is the main clinical manifestation, the course of the disease is benign, the long-term prognosis is good, and renal function remains normal for a long time. Microscopic hematuria can often be found when examining direct relatives.

The diagnosis of this disease relies on renal puncture biopsy, and the diffuse thinning of the glomerular basement membrane found by electron microscopy is the gold standard for diagnosis. However, because renal puncture is an invasive examination and the development of this disease is benign, renal puncture biopsy is generally not recommended.