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Autosomal Recessive Renal Tubular Dysgenesis (RTD) Panel

Summary and Pricing

Test Method

Exome Sequencing with CNV Detection
Test Code Test Copy Genes Gene CPT Codes Copy CPT Codes
ACE 81479,81479
AGT 81479,81479
AGTR1 81479,81479
REN 81479,81479
Test Code Test Copy Genes Panel CPT Code Gene CPT Codes Copy CPT Code Base Price
10151Genes x (4)81479 81479(x8) $990 Order Options and Pricing

Pricing Comments

We are happy to accommodate requests for testing single genes in this panel or a subset of these genes. The price will remain the list price. If desired, free reflex testing to remaining genes on panel is available. Alternatively, a single gene or subset of genes can also be ordered via our Custom Panel tool.

An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.

Click here for costs to reflex to whole PGxome (if original test is on PGxome Sequencing platform).

Click here for costs to reflex to whole PGnome (if original test is on PGnome Sequencing platform).

Turnaround Time

3 weeks on average for standard orders or 2 weeks on average for STAT orders.

Please note: Once the testing process begins, an Estimated Report Date (ERD) range will be displayed in the portal. This is the most accurate prediction of when your report will be complete and may differ from the average TAT published on our website. About 85% of our tests will be reported within or before the ERD range. We will notify you of significant delays or holds which will impact the ERD. Learn more about turnaround times here.

Targeted Testing

For ordering sequencing of targeted known variants, go to our Targeted Variants page.


Genetic Counselors


  • Angela Gruber, PhD

Clinical Features and Genetics

Clinical Features

Autosomal recessive renal tubular dysgenesis (RTD) is a severe disorder of renal tubular development characterized by early onset of persistent anuria (leading to oligohydramnios) and the absence or incomplete differentiation of proximal tubules (Gribouval et al. 2005; Gribouval et al. 2012). Affected individuals may die in utero or within 24 hours of birth. The histopathological hallmark of the disease is absence or paucity of differentiated proximal tubules, which may be associated with skull ossification defects. Renal lesions and early anuria result from renin-angiotensin system inactivity caused by defects in the genes encoding renin (REN), angiotensinogen (AGT), angiotensin converting enzyme (ACE) or angiotensin II receptor type 1 (AGTR1).


Autosomal recessive renal tubular dysgenesis is a consequence of renin-angiotensin system inactivity caused by defects in the genes encoding renin (REN), angiotensinogen (AGT), angiotensin converting enzyme (ACE) or angiotensin II receptor type 1 (AGTR1) (Gribouval et al. 2005; Gribouval et al. 2012). These genes play a crucial role in the reninangiotensin system during human kidney development. Genetic defects of the REN, AGT, ACE and AGTR1 genes found in renal tubular dysgenesis include missense, nonsense, splicing mutations and small deletion/insertions (Human Gene Mutation Database). Exon-level large deletions have only been reported in the ACE gene, but uncommon. AGT encodes pre-angiotensinogen or angiotensinogen precursor, which is synthesized mainly by the liver and then cleaved by the enzyme renin to form angiotensin I. This peptide is the start point of a cascade that can result in aldosterone release, vasoconstriction and increase in blood pressure. The REN gene is mainly expressed in the granular cells of the juxtaglomerular apparatus of the kidney. Its final protein product, termed renin, is an aspartyl protease, which catalyzes the first step in the activation pathway of angiotensinogen. It cleaves angiotensinogen to form angiotensin I, which is converted to angiotensin II by the angiotensin I converting enzyme (ACE). The ACE gene encodes the angiotensin I converting enzyme, which is an important regulator of blood pressure and electrolyte balance. It catalyzes the conversion of angiotensin I into a physiologically active peptide angiotensin II, which is a potent vasopressor and aldosterone-stimulating peptide that controls blood pressure and fluid-electrolyte balance. The AGTR1 gene encodes the angiotensin II type 1 receptor (AT1), which belongs to the G-protein-coupled receptor superfamily. This receptor is thought to mediate the major cardiovascular effects of angiotensin II and play a role in the generation of reperfusion arrhythmias following restoration of blood flow to ischemic or infarcted myocardium.

Clinical Sensitivity - Sequencing with CNV PGxome

In the most comprehensive study by far of 48 autosomal recessive RTD families (Gribouval et al. 2012), mutations were found in one of the REN, AGT, ACE and AGTR1 genes for all cases fulfilling the clinical, pathological, and immunohistochemical criteria for RTD. The mutation detection rates were ACE (31 families; 64.6%), REN (10 families; 20.8%), AGT (4 families; 8.3%) and AGTR1 (3 families; 6.3%). Exon-level copy number changes were found to be very rare in these genes, and the mutation detection rate via sequencing is expected to be near 100% for cases fulfilling the clinical, pathological, and immunohistochemical criteria for RTD.

Testing Strategy

This test is performed using Next-Gen sequencing with additional Sanger sequencing as necessary.

This panel provides 100% coverage of all coding exons of the genes plus 10 bases of flanking noncoding DNA in all available transcripts along with other non-coding regions in which pathogenic variants have been identified at PreventionGenetics or reported elsewhere. We define coverage as ≥20X NGS reads or Sanger sequencing. PGnome panels typically provide slightly increased coverage over the PGxome equivalent. PGnome sequencing panels have the added benefit of additional analysis and reporting of deep intronic regions (where applicable).

Dependent on the sequencing backbone selected for this testing, discounted reflex testing to any other similar backbone-based test is available (i.e., PGxome panel to whole PGxome; PGnome panel to whole PGnome).

Indications for Test

Candidates for this test are patients with autosomal recessive renal tubular dysgenesis. Testing is also indicated for family members of patients who have known mutations in the REN, AGT, ACE and AGTR1 genes.


Official Gene Symbol OMIM ID
ACE 106180
AGT 106150
AGTR1 106165
REN 179820
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT


Name Inheritance OMIM ID
Renal Tubular Dysgenesis AR 267430

Related Test



  • Gribouval O, Gonzales M, Neuhaus T, Aziza J, Bieth E, Laurent N, Bouton JM, Feuillet F, Makni S, Amar H Ben, Laube G, Delezoide A-L, et al. 2005. Mutations in genes in the renin-angiotensin system are associated with autosomal recessive renal tubular dysgenesis. Nat. Genet. 37: 964–968. PubMed ID: 16116425
  • Gribouval O, Morinière V, Pawtowski A, Arrondel C, Sallinen S-L, Saloranta C, Clericuzio C, Viot G, Tantau J, Blesson S, Cloarec S, Machet MC, et al. 2012. Spectrum of mutations in the renin-angiotensin system genes in autosomal recessive renal tubular dysgenesis. Hum. Mutat. 33: 316–326. PubMed ID: 22095942
  • Human Gene Mutation Database (Bio-base).


Ordering Options

We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.

myPrevent - Online Ordering

  • The test can be added to your online orders in the Summary and Pricing section.
  • Once the test has been added log in to myPrevent to fill out an online requisition form.
  • PGnome sequencing panels can be ordered via the myPrevent portal only at this time.

Requisition Form

  • A completed requisition form must accompany all specimens.
  • Billing information along with specimen and shipping instructions are within the requisition form.
  • All testing must be ordered by a qualified healthcare provider.

For Requisition Forms, visit our Forms page

If ordering a Duo or Trio test, the proband and all comparator samples are required to initiate testing. If we do not receive all required samples for the test ordered within 21 days, we will convert the order to the most effective testing strategy with the samples available. Prior authorization and/or billing in place may be impacted by a change in test code.

Specimen Types

Specimen Requirements and Shipping Details

PGxome (Exome) Sequencing Panel

PGnome (Genome) Sequencing Panel

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