Deficiency in the Screening Process of Fabry Disease: Analysis of Chronic Kidney Patients Not on Dialysis

Yuri Battaglia, Fulvio Fiorini, Cristiano Azzini, Pasquale Esposito, Alessandro De vito, Antonio Granata, Alda Storari, Renzo Mignani

Research output: Contribution to journalReview articlepeer-review

Abstract

Fabry Disease (FD), a rare and progressive, X-linked lysosomal storage disorder, is caused by mutations in the α-galactosidase A (GLA) gene which leads to enzymatic deficiency of GLA. Misdiagnosed and undiagnosed FD cases are common for the variable FD phenotype, ranging from asymptomatic and/or impairment of single organs, which is typically seen in females and in patients with late-onset mutation, to multiple organ disease, which is frequently found in males with classic GLA mutation. Consequently, for an early diagnosis and an efficient treatment of FD, three different strategies of screening, new-born screening, high-risk screening and familiar screening, have been conducted. However, most of FD screening in the CKD population has been carried out in hemodialysis patients and kidney transplant recipients, for whom the renal damage is already irreversible, so the effectiveness of enzymatic replacement therapy is limited and delayed therapeutic intervention results in worse long-term outcomes. This review investigates the actual strategies of screening initiatives for the identification of FD, examining in detail those performed in CKD patients not on dialysis.

Original languageEnglish
Article number640876
JournalFrontiers in Medicine
Volume8
DOIs
Publication statusPublished - Feb 9 2021

Keywords

  • chronic kidney disease
  • Fabry disease
  • lysosomal disorders
  • prevention
  • screening

ASJC Scopus subject areas

  • Medicine(all)

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