Mutations in KIRREL1, a slit diaphragm component, cause steroid-resistant nephrotic syndrome

Ashish K. Solanki, Eugen Widmeier, Ehtesham Arif, Shailza Sharma, Ankana Daga, Pankaj Srivastava, Sang Ho Kwon, Hannah Hugo, Makiko Nakayama, Nina Mann, Amar J. Majmundar, Wei Tan, Heon Yung Gee, Caroline E. Sadowski, Choni Rinat, Rachel Becker-Cohen, Carsten Bergmann, Seymour Rosen, Michael Somers, Shirlee ShrilTobias B. Huber, Shrikant Mane, Friedhelm Hildebrandt, Deepak Nihalani

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Steroid-resistant nephrotic syndrome is a frequent cause of chronic kidney disease almost inevitably progressing to end-stage renal disease. More than 58 monogenic causes of SRNS have been discovered and majority of known steroid-resistant nephrotic syndrome causing genes are predominantly expressed in glomerular podocytes, placing them at the center of disease pathogenesis. Herein, we describe two unrelated families with steroid-resistant nephrotic syndrome with homozygous mutations in the KIRREL1 gene. One mutation showed high frequency in the European population (minor allele frequency 0.0011) and this patient achieved complete remission following treatment, but later progressed to chronic kidney disease. We found that mutant KIRREL1 proteins failed to localize to the podocyte cell membrane, indicating defective trafficking and impaired podocytes function. Thus, the KIRREL1 gene product has an important role in modulating the integrity of the slit diaphragm and maintaining glomerular filtration function.

Original languageEnglish (US)
Pages (from-to)883-889
Number of pages7
JournalKidney International
Issue number4
StatePublished - Oct 2019


  • focal segmental glomerulosclerosis
  • minimal change disease
  • steroid-resistant nephrotic syndrome

ASJC Scopus subject areas

  • Nephrology


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