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Review
. 2021 Mar;36(3):711-719.
doi: 10.1007/s00467-020-04819-6. Epub 2020 Nov 6.

Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults-an update for 2020

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Review

Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults-an update for 2020

Clifford E Kashtan et al. Pediatr Nephrol. 2021 Mar.

Erratum in

Abstract

In 2013, we published a set of clinical practice recommendations for the treatment of Alport syndrome in this journal. We recommended delaying the initiation of angiotensin-converting enzyme inhibition until the onset of overt proteinuria or, in some cases, microalbuminuria. Developments that have occurred over the past 7 years have prompted us to revise these recommendations. We now recommend the initiation of treatment at the time of diagnosis in males with X-linked Alport syndrome and in males and females with autosomal recessive Alport syndrome. We further recommend starting treatment at the onset of microalbuminuria in females with X-linked Alport syndrome and in males and females with autosomal dominant Alport syndrome. This article presents the rationale for these revisions as well as recommendations for diagnostic tactics intended to ensure the early diagnosis of Alport syndrome.

Trial registration: ClinicalTrials.gov NCT00481130 NCT03019185 NCT02855268 NCT02378805 NCT01485978 NCT03019185 NCT02855268.

Keywords: Alport syndrome; Angiotensin-converting enzyme inhibition; Collagen IV; Hematuria; Microalbuminuria; Proteinuria; Treatment recommendations.

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Comment in

References

    1. Kashtan CE, Ding J, Gregory M, Gross O, Heidet L, Knebelmann B, Rheault M, Licht C (2013) Clinical practice recommendations for the treatment of Alport syndrome: a statement of the Alport syndrome research collaborative. Pediatr Nephrol 28:5–11 - PubMed
    1. Gross O, Licht C, Anders HJ, Hoppe B, Beck B, Tönshoff B, Hocker B, Wydoga S, Ehrich JH, Pape L, Konrad M, Rasher W, Dotsch J, Muller-Wierfel DE, Hoyer P, Knebelmann B, Pirson Y, Grunfeld JP, Niaudet P, Cochat P, Heidet L, Lebbah S, Torra R, Friede T, Lange K, Muller GA, Weber M, Study Group Members of the Gesellschart fur Padiatrische Nephrologie (2012) Early angiotensin-converting enzyme inhibition in Alport syndrome delays renal failure and improves life expectancy. Kidney Int 81:494–501 - PubMed
    1. Barker DF, Hostikka SL, Zhou J, Chow LT, Oliphant AR, Gerken SC, Gregory MC, Skolnick MH, Atkin CL, Tryggvason K (1990) Identification of mutations in the COL4A5 collagen gene in Alport syndrome. Science 248:1224–1227 - PubMed
    1. Boye E, Mollet G, Forestier L, Cohen-Solal L, Heidet L, Cochat P, Grunfeld JP, Palcoux JB, Gubler MC, Antignac C (1998) Determination of the genomic structure of the COL4A4 gene and of novel mutations causing autosomal recessive Alport syndrome. Am J Hum Genet 63:1329–1340 - PubMed - PMC
    1. Heidet L, Arrondel C, Forestier L, Cohen-Solal L, Mollet G, Gutierrez B, Stavrou C, Gubler MC, Antignac C (2001) Structure of the human type IV collagen gene COL4A3 and mutations in autosomal Alport syndrome. J Am Soc Nephrol 12:97–106 - PubMed

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