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Polycystic Kidney Disease, Autosomal Dominant (PKD1 and PKD2) Sequencing
2012255
Ordering Recommendation

Acceptable test for molecular confirmation of suspected clinical diagnosis of autosomal dominant polycystic kidney disease (ADPKD).

Mnemonic
ADPKD FGS
Methodology
Polymerase Chain Reaction/Sequencing
Performed
Sun-Sat
Reported
28-35 days
New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). 
Specimen Preparation
Transport 3 mL whole blood. (Min: 1 mL) 
Storage/Transport Temperature
Refrigerated. 
Unacceptable Conditions
 
Remarks
 
Stability
Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable 
Reference Interval
Interpretive Data
Background Information for Polycystic Kidney Disease, Autosomal Dominant (PKD1 and PKD2) Sequencing
Characteristics:
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is typically an adult-onset, multisystem disorder. Renal findings include: bilateral renal cysts, renal insufficiency, renal pain, hypertension, dilated renal tubules, enlarged kidneys, and end-stage renal disease (ESRD). Extra-renal findings include cysts in other organs, including liver, pancreas, seminal vesicles, and arachnoid membrane. Connective tissue findings include intracranial aneurysms, dolichoectasia, dilation of the aortic root, aortic dissections, mitral valve prolapse, and abdominal wall hernias. Fifty percent of individuals with ADPKD will develop ESRD by age 60.
Prevalence: 1:500-1:1,000 in the U.S.
Inheritance: Autosomal dominant; 5-10 percent of cases are de novo.
Penetrance: Age-dependent; nearly all older adults develop multiple renal cysts. The average age of onset for ESRD in individuals with PKD1 and PKD2 mutations is 54 and 74 years, respectively.
Cause: Pathogenic PKD1 or PKD2 gene mutations. In cases with an identifiable molecular cause, 85 percent are attributed to PKD1 and 15 percent are attributed to PKD2.
Clinical Sensitivity: Estimated at 87 percent for ADPKD.
Methodology: Bidirectional sequencing of the entire coding region and intron/exon boundaries of the PKD1 and PKD2 genes. A large region of PKD1, including exons 1-33, is duplicated six times on the same chromosome; therefore, to distinguish the PKD1 gene from the PKD1-like pseudogenes, long range PCR followed by site-specific PCR is used to sequence PKD1 exons 1-33.
Analytical Sensitivity and Specificity: 99 percent.
Limitations:
Diagnostic errors can occur due to rare sequence variations. Large deletions/duplications, regulatory region mutations and deep intronic mutations in PKD1 or PKD2 will not be detected. Mosaic mutations in PKD1 or PKD2 may not be detected. Mutations in genes other than PKD1 and PKD2 are not assessed by this assay.

Compliance Statement C: The performance characteristics of this test were validated by ARUP Laboratories. The U.S. Food and Drug Administration (FDA) has not approved or cleared this test. However, FDA approval or clearance is currently not required for clinical use of this test. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing. Counseling and informed consent are recommended for genetic testing. Consent forms are available online.

Components
Component Test Code*Component Chart NameLOINC
2012256ADPKD Sequencing Specimen31208-2
2012257ADPKD Sequencing Interpretation44421-6
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Aliases
  • ADPKD
  • Adult polycystic kidney disease (APKD)
  • Autosomal dominant polycystic kidney disease
  • Polycystic kidney disease type 1
  • Polycystic kidney disease type 2