Highlights & Basics
- Alport syndrome is a rare familial nephropathy due to abnormalities in type IV collagen.
- May be inherited in 1 of 4 patterns: X-linked, autosomal recessive, autosomal dominant or autosomal digenic.
- Associated with considerable clinical variability of age of onset of chronic kidney disease or end-stage kidney disease. Frequently associated with sensorineural hearing loss.
- Females with X-linked Alport syndrome have a significant lifetime risk of developing hypertension and chronic renal disease.
- Strong genotype-phenotype correlations in X-linked Alport syndrome have been described in male patients.
Quick Reference
History & Exam
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Definition
Epidemiology
Etiology
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Citations
Kashtan CE, Ding J, Garosi G, et al. Alport syndrome: a unified classification of genetic disorders of collagen IV alpha345: a position paper of the Alport Syndrome Classification Working Group. Kidney Int. 2018 May;93(5):1045-51.[Abstract][Full Text]
Savige J, Lipska-Zietkiewicz BS, Watson E, et al. Guidelines for genetic testing and management of Alport syndrome. Clin J Am Soc Nephrol. 2022 Jan;17(1):143-54.[Abstract][Full Text]
Flinter FA, Cameron JS, Chantler C, et al. Genetics of classic Alport's syndrome. Lancet. 1988 Oct 29;2(8618):1005-7.[Abstract]
Kashtan CE, Gross O. Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults-an update for 2020. Pediatr Nephrol. 2021 Mar;36(3):711-9.[Abstract]
Gross O, Tönshoff B, Weber LT, et al. A multicenter, randomized, placebo-controlled, double-blind phase 3 trial with open-arm comparison indicates safety and efficacy of nephroprotective therapy with ramipril in children with Alport's syndrome. Kidney Int. 2020 Jun;97(6):1275-86.[Abstract][Full Text]
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24. Hanson H, Storey H, Pagan J, et al. The value of clinical criteria in identifying patients with X-linked Alport syndrome. Clin J Am Soc Nephrol. 2011 Jan;6(1):198-203.[Abstract][Full Text]
25. Flinter FA, Cameron JS, Chantler C, et al. Genetics of classic Alport's syndrome. Lancet. 1988 Oct 29;2(8618):1005-7.[Abstract]
26. Perrin D, Jungers P, Grunfeld JP, et al. Perimacular changes in Alport's syndrome. Clin Nephrol. 1980 Apr;13(4):163-7.[Abstract]
27. Savige J, Storey H, Watson E, et al. Consensus statement on standards and guidelines for the molecular diagnostics of Alport syndrome: refining the ACMG criteria. Eur J Hum Genet. 2021 Aug;29(8):1186-97.[Abstract][Full Text]
28. Kashtan CE, Segal Y, Flinter F, et al. Aortic abnormalities in males with Alport syndrome. Nephrol Dial Transplant. 2010 Nov;25(11):3554-60.[Abstract]
29. Savige J, Colville D, Rheault M, et al. Alport syndrome in women and girls. Clin J Am Soc Nephrol. 2016 Sep 7;11(9):1713-20.[Abstract][Full Text]
30. Kashtan CE, Gross O. Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults-an update for 2020. Pediatr Nephrol. 2021 Mar;36(3):711-9.[Abstract]
31. Martin P, Heiskari N, Zhou J, et al. High mutation detection rate in the COL4A5 collagen gene in suspected Alport syndrome using PCR and direct DNA sequencing. J Am Soc Nephrol. 1998 Dec;9(12):2291-301.[Abstract][Full Text]
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45. Kashtan CE. Renal transplantation in patients with Alport syndrome: patient selection, outcomes, and donor evaluation. Int J Nephrol Renovasc Dis. 2018 Oct 16:11:267-70. [Abstract][Full Text]
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50. Torra R, Furlano M. New therapeutic options for Alport syndrome. Nephrol Dial Transplant. 2019 Aug 1;34(8):1272-9.[Abstract][Full Text]
51. Webb NJ, Lam C, Shahinfar S, et al. Efficacy and safety of losartan in children with Alport syndrome - results from a subgroup analysis of a prospective, randomized, placebo- or amlodipine-controlled trial. Nephrol Dial Transplant. 2011 Aug;26(8):2521-6.[Abstract]
52. Webb NJ, Shahinfar S, Wells TG, et al. Losartan and enalapril are comparable in reducing proteinuria in children with Alport syndrome. Pediatr Nephrol. 2013 May;28(5):737-43.[Abstract]
53. Kashtan CE. Renal transplantation in patients with Alport syndrome. Pediatr Transplant. 2006 Sep;10(6):651-7.[Abstract]
54. Gillion V, Dahan K, Cosyns JP, et al. Genotype and Outcome After Kidney Transplantation in Alport Syndrome. Kidney Int Rep. 2018 May;3(3):652-660.[Abstract][Full Text]
55. Gross O, Weber M, Fries JW, et al. Living donor kidney transplantation from relatives with mild urinary abnormalities in Alport syndrome: long-term risk, benefit and outcome. Nephrol Dial Transplant. 2009 May;24(5):1626-30.[Abstract][Full Text]
56. Kashtan CE. Women with Alport syndrome: risks and rewards of kidney donation. Nephrol Dial Transplant. 2009 May;24(5):1369-70.[Abstract][Full Text]
57. Shukla AM, Hinkamp C, Segal E, et al. What do the US advanced kidney disease patients want? Comprehensive pre-ESRD patient education (CPE) and choice of dialysis modality. PLoS One. 2019 Apr 9;14(4):e0215091.[Abstract][Full Text]
58. Mastrangelo A, Brambilla M, Romano G, et al. Single, double and triple blockade of RAAS in Alport syndrome: different tools to freeze the evolution of the disease. J Clin Med. 2021 Oct 26;10(21):4946.[Abstract][Full Text]
59. Kaito H, Nozu K, Iijima K, et al. The effect of aldosterone blockade in patients with Alport syndrome. Pediatr Nephrol. 2006 Dec;21(12):1824-9.[Abstract]
60. Charbit M, Gubler MC, Dechaux M, et al. Cyclosporin therapy in patients with Alport syndrome. Pediatr Nephrol. 2007 May;22(5):57-63.[Abstract]
61. Chertow GM, Appel GB, Andreoli S, et al. Study design and baseline characteristics of the CARDINAL trial: a phase 3 study of bardoxolone methyl in patients with Alport syndrome. Am J Nephrol. 2021;52(3):180-9.[Abstract][Full Text]
62. Storey H, Savige J, Sivakumar V, et al. COL4A3/COL4A4 mutations and features in individuals with autosomal recessive Alport syndrome. J Am Soc Nephrol. 2013 Dec;24(12):1945-54.[Abstract]
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