Fabry nephropathy: an evidence-based narrative review

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2018
Author
Pino, María Dolores del
Andrés, Amado
Ávila Bernabéu, Ana
Juan-Rivera, Joaquín de
Fernández i Giráldez, Elvira
García Díaz, Juan de Dios
Hernández, Domingo
Luño, José
Martínez Fernández, Isabel
Paniagua, José
Torra, Roser
Torras Ambros, Joan
Vidau, Pedro
Torregrosa, Josep-Vicent
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Pino, María Dolores del; Andrés, Amado; Ávila Bernabéu, Ana; Juan-Rivera, Joaquín de; Fernández i Giráldez, Elvira; García Díaz, Juan de Dios; ... Torregrosa, Josep-Vicent. (2018) . Fabry nephropathy: an evidence-based narrative review. Kidney and Blood Pressure Research, 2018, vol. 43, núm. 2, p.406-421. https://doi.org/10.1159/000488121.
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Abstract
Fabry disease (FD) is a rare, X-linked disorder caused by mutations in the GLA gene encoding the enzyme α-galactosidase A. Complete or partial deficiency in this enzyme leads to intracellular accumulation of globotriaosylceramide (Gb3) and other glycosphingolipids in many cell types throughout the body, including the kidney. Progressive accumulation of Gb3 in podocytes, endothelial cells, epithelial cells, and tubular cells contribute to the renal symptoms of FD, which manifest as proteinuria and reduced glomerular filtration rate leading to renal insufficiency. A correct diagnosis of FD, although challenging, has considerable implications regarding treatment, management, and counseling. The diagnosis may be confirmed by demonstrating the enzyme deficiency in males and by identifying the specific GLA gene mutation in male and female patients. Treatment with enzyme replacement therapy, as part of the therapeutic strategy to prevent complications of the disease, may be beneficial in stabilizing renal function or slowing its decline, particularly in the early stages of the disease. Emergent treatments for FD include the recently approved chaperone molecule migalastat for patients with amenable mutations. The objective of this report is to provide an updated overview on Fabry nephropathy, with a focus on the most relevant aspects of its epidemiology, diagnosis, pathophysiology, and treatment options.
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http://hdl.handle.net/10459.1/63091
DOI
https://doi.org/10.1159/000488121
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Kidney and Blood Pressure Research, 2018, vol. 43, núm. 2, p.406-421
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cc-by-nc-nd (c) Pino et al., 2018
Except where otherwise noted, this item's license is described as cc-by-nc-nd (c) Pino et al., 2018