Sequence variants in the renin–angiotensin system genes are associated with isolated multicystic dysplastic kidney in children

Background Multicystic dysplastic kidney (MCDK) is a common form of congenital cystic kidney disease in children. The etiology of MCDK remains unclear. Given an important role of the renin–angiotensin system in normal kidney development, we explored whether MCDK in children is associated with variants in the genes encoding renin–angiotensin system components by Sanger sequencing. Methods The coding regions of renin ( REN ), angiotensinogen ( AGT ), ACE , and angiotensin 1 receptor ( AGTR1 ) genes were amplified by PCR. The effect of DNA sequence variants on protein function was predicted with PolyPhen-2 software. Results 3 novel and known AGT variants were found. 1 variant was probably damaging, 1 was possibly damaging and one was benign. Out of 7 REN variants, 4 were probably damaging and 3 were benign. Of 6 ACE variants, 3 were probably damaging and 3-benign. 3 AGTR1 variants were found. 2 variants were possibly damaging, and one was benign. Conclusion We report novel associations of sequence variants in REN , AGT , ACE , or AGTR1 genes in children with isolated MCDK in the United States. Our findings suggest a recessive disease model and support the hypothesis of multiple renin–angiotensin system gene involvement in MCDK. Impact Discovery of novel gene variants in renin–angiotensin genes in children with MCDK. Novel possibly damaging gene variants discovered. Multiple renin–angiotensin system gene variants are involved in MCDK.