The Genetics of Renal Disease by Frances Flinter, Eamonn Maher, Anand Saggar-Malik

By Frances Flinter, Eamonn Maher, Anand Saggar-Malik

Guy's health facility, London, united kingdom. presents a finished account of the hereditary nephropathies and extra generalized problems which could impact the renal tract. formerly released because the Genetics of Renal Tract problems, via M. D'A Crawfurd, c1988. For scientific geneticists and researchers. Illustrated.

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The various conditions are very disparate. The original work of Goldblatt et al. (1934) suggested that the relief of renal artery narrowing will cure the hypertension the renal ischaemia induces. A major focus on the management of these conditions is to re-establish the normal blood flow to the kidney. Initially the early reports were of nephrectomy or renal artery surgery. The introduction of renal angioplasty and more recently renal artery stenting has meant that renal revascularization can be achieved without a significant surgical operation.

In the latter situation, testing can only be justified if it will result in psychological or social benefit and, at the very least, do the child no harm. However, there is little evidence as to whether carrier testing is harmful or beneficial to the child or the family and research studies in this area are scarce. One central anxiety arises from potential damage caused by possible changes in the attitude of a parent towards a child who is identified as genetically ‘different’. Childhood testing raises many issues to do with parental rights and responsibilities.

The work of Parving et al. (1983) has shown that tight control of hypertension can cause a decrease in the rate of decline of renal function. This group of patients has been the most easy to study given its homogeneity. The results appear applicable to all forms of renal damage including post-transplantation. In the clinical setting, for conditions such as APKD where there are no specific ameliorative gene therapies at present, we can offer the patient the possibility of altering the rate of decline of renal function by tight blood pressure control.

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