Publications by authors named "N Knoers"

Article Synopsis
  • Chronic kidney disease (CKD) is unexplained in 20% of patients, and this study investigates the use of massively parallel sequencing (MPS) as a diagnostic tool for these cases.
  • The study found that in 340 participants, a genetic diagnosis was identified in 17% of cases, leading to clinical consequences in 73% of those diagnosed.
  • Barriers to implementation of genetic testing included genetic illiteracy among nephrologists, difficulties in test selection, and lack of time, highlighting the need for better education in genetics.
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Article Synopsis
  • * Prenatal and preimplantation genetic testing options are discussed, emphasizing their importance for families, especially those considering having children, along with the associated legal and ethical issues.
  • * Noninvasive prenatal diagnosis is emerging as a promising alternative to invasive testing, while preimplantation genetic testing is increasingly sought after to select healthy embryos, particularly in disorders with late-onset symptoms.
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Congenital nephrogenic diabetes insipidus (NDI; also known as arginine vasopressin resistance) is a rare inherited disorder of water homeostasis, caused by insensitivity of the distal nephron to arginine vasopressin. Consequently, the kidney loses its ability to concentrate urine, which leads to polyuria, polydipsia and the risk of hypertonic dehydration. The diagnosis and management of NDI are very challenging and require an integrated, multidisciplinary approach.

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Mounting evidence indicates that monogenic disorders are the underlying cause in a significant proportion of patients with CKD. In recent years, the diagnostic yield of genetic testing in these patients has increased significantly as a result of revolutionary developments in genetic sequencing techniques and sequencing data analysis. Identification of disease-causing genetic variant(s) in patients with CKD may facilitate prognostication and personalized management, including nephroprotection and decisions around kidney transplantation, and is crucial for genetic counseling and reproductive family planning.

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Leukemias are genetically heterogeneous and diagnostics therefore includes various standard-of-care (SOC) techniques, including karyotyping, SNP-array and FISH. Optical genome mapping (OGM) may replace these as it detects different types of structural aberrations simultaneously and additionally detects much smaller aberrations (500 bp vs 5-10 Mb with karyotyping). However, its resolution may still be too low to define clinical relevance of aberrations when they are located between two OGM labels or when labels are not distinct enough.

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