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Genetic testing identified positive findings in 24% of CKD patients and changed management in most casesGenetic testing found helpful for diagnosis and management in some chronic kidney disease patients

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Key Takeaway
Consider genetic testing's reported utility in CKD management cautiously, as evidence comes from a single-arm study.

In a single-arm, prospective, multicenter study, 1388 adult chronic kidney disease (CKD) patients across 13 clinical categories underwent genetic testing with a 385-gene panel (Renasight test). The study assessed diagnostic and clinical utility through physician questionnaires at 1 month and 1 year after testing, with 1174 patients included in the 1-year analysis. No comparator group was used, and the primary outcome was not reported.

At 1 year, 335 of 1388 patients (24%) had a positive genetic finding. Physicians reported the genetic testing was 'helpful/changed management' in 86% of cases with positive findings and 42% of cases with negative findings. Physician estimation of the patient's 5-year prognosis changed in 55% of positive cases and 18% of negative cases. The study reported utility across various clinical cohorts, including CKD of unknown etiology and hypertension or diabetes-related nephropathy.

Safety and tolerability data were not reported. The key limitation is the single-arm design without a control group, preventing comparison to standard care. Results are based on physician-reported helpfulness and management changes rather than measured patient outcomes. The study cannot establish that genetic testing improves clinical outcomes.

For practice, this observational evidence suggests broad-panel genetic testing may have diagnostic and management utility in selected CKD patients, particularly those with unknown etiology. However, the absence of a comparator and reliance on physician questionnaires mean these findings should be interpreted cautiously while awaiting controlled studies.

Researchers studied whether a broad genetic test could help diagnose and manage chronic kidney disease (CKD). They enrolled 1,388 adult patients with CKD from various medical centers and tested them using a panel that looks for changes in 385 genes. The study followed patients for one year after testing to see how the results affected their care.

In the study, about 24% of patients (335 people) had a positive genetic finding. For patients with a positive result, their doctors reported that the genetic information was helpful or changed their management plan 86% of the time. Even for patients with a negative result, doctors said the test was helpful 42% of the time. The test also led doctors to change their five-year outlook on the disease for 55% of patients with a positive result and 18% with a negative result.

It is important to be cautious about these results. The study did not have a control group, meaning there was no comparison to patients who did not get genetic testing. The reported benefits are based on what doctors said on questionnaires, not on measured improvements in patient health outcomes like kidney function or survival. The study also did not report on any safety concerns or side effects from the testing process.

For now, this research suggests genetic testing may provide useful information for some people with CKD and their doctors. However, more research with comparison groups is needed to understand if this testing actually leads to better long-term health for patients.

What this means for you:
Genetic testing may inform CKD care, but its effect on patient health needs more study.

Study Details

EvidenceLevel 5
Follow-up1.0 mo
PublishedApr 2026
View Original Abstract ↓
KEY POINTS: Genetic testing in CKD showed diagnostic and clinical utility in the year following reporting of test results. Genetic testing was helpful for or changed management in 86% of patients with a positive finding and 42% with a negative finding. Clinical utility was seen across 12 clinical cohorts, including CKD of unknown etiology and hypertension or diabetes-related nephropathy. BACKGROUND: CKD is a significant public health burden, affecting >800 million people worldwide with significant cost to the health care system. CKD is a disease process with substantial genetic and phenotypic heterogeneity that can obscure a definitive diagnosis, resulting in suboptimal management. Recent guidelines support greater adoption of genetic testing in CKD. We assessed the diagnostic and clinical utility in the year following broad-panel CKD genetic testing. METHODS: The Renasight Clinical Application, Review, and Evaluation (RenaCARE) study ( NCT05846113 ) was a single-arm, interventional, prospective, multicenter study evaluating the utility of genetic testing with a 385-gene panel on the diagnosis and management of CKD. Clinical history was collected before testing, and nephrologists responded to questionnaires at both 1 month and 1 year after testing. The impact of genetic testing on CKD diagnosis and management were assessed in active study patients at the 1-year time point. RESULTS: In a cohort of 1388 CKD patients with 13 pretest clinical categories of CKD, 335 (24%) patients had a positive genetic finding; 1174 had a questionnaire completed at 1 year and were included in the analysis. Genetic testing was reported helpful for clinical management and/or led to a change in management in 86% of patients with a positive test finding and 42% of patients with a negative test finding. In addition, genetic testing resulted in a change in the physician estimation of the 5-year prognosis for 55% of patients with a positive test finding and 18% of those with a negative test finding. CONCLUSIONS: Supporting the previous results of the RenaCARE study at 1 month, this report demonstrated that genetic testing was helpful in the clinical management and estimated prognosis of patients with CKD. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: ClinicalTrials.gov, NCT05846113 .
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