chr1-204159399-C-T
Variant names: 
Variant summary
Our verdict is Likely pathogenic. The variant received 7 ACMG points: 7P and 0B. PM2PP3_StrongPP5
The NM_000537.4(REN):c.689G>A(p.Arg230Lys) variant causes a missense, splice region change. The variant allele was found at a frequency of 0.00000137 in 1,461,784 control chromosomes in the GnomAD database, with no homozygous occurrence. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Pathogenic (no stars).
Frequency
 Genomes: not found (cov: 32) 
 Exomes 𝑓:  0.0000014   (  0   hom.  ) 
Consequence
 REN
NM_000537.4 missense, splice_region
NM_000537.4 missense, splice_region
Scores
 1
 8
 10
 Splicing: ADA:  1.000  
 2
Clinical Significance
Conservation
 PhyloP100:  4.74  
Publications
4 publications found 
Genes affected
 REN  (HGNC:9958):  (renin) This gene encodes renin, an aspartic protease that is secreted by the kidneys. Renin is a part of the renin-angiotensin-aldosterone system involved in regulation of blood pressure, and electrolyte balance. This enzyme catalyzes the first step in the activation pathway of angiotensinogen by cleaving angiotensinogen to form angiotensin I, which is then converted to angiotensin II by angiotensin I converting enzyme. This cascade can result in aldosterone release, narrowing of blood vessels, and increase in blood pressure as angiotension II is a vasoconstrictive peptide. Transcript variants that encode different protein isoforms and that arise from alternative splicing and the use of alternative promoters have been described, but their full-length nature has not been determined. Mutations in this gene have been shown to cause hyperuricemic nephropathy familial juvenile 2, familial hyperproreninemia, and renal tubular dysgenesis. [provided by RefSeq, May 2020] 
REN Gene-Disease associations (from GenCC):
- familial juvenile hyperuricemic nephropathy type 2Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics, Labcorp Genetics (formerly Invitae), ClinGen
 - renal tubular dysgenesis of genetic originInheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), ClinGen, Orphanet, Ambry Genetics
 
Genome browser will be placed here
ACMG classification
Classification was made for transcript
Our verdict: Likely_pathogenic. The variant received 7 ACMG points.
PM2
Very rare variant in population databases, with high coverage; 
PP3
Splicing predictors support a deleterious effect. Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF. Scorers claiming Uncertain: max_spliceai. No scorers claiming Benign. 
PP5
Variant 1-204159399-C-T is Pathogenic according to our data. Variant chr1-204159399-C-T is described in ClinVar as Pathogenic. ClinVar VariationId is 13124.Status of the report is no_assertion_criteria_provided, 0 stars. 
Transcripts
RefSeq
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt | 
|---|---|---|---|---|---|---|---|---|---|---|
| REN | ENST00000272190.9  | c.689G>A | p.Arg230Lys | missense_variant, splice_region_variant | Exon 5 of 10 | 1 | NM_000537.4 | ENSP00000272190.8 | ||
| REN | ENST00000638118.1  | c.575G>A | p.Arg192Lys | missense_variant, splice_region_variant | Exon 7 of 12 | 5 | ENSP00000490307.1 | 
Frequencies
GnomAD3 genomes  Cov.: 32 
GnomAD3 genomes 
Cov.: 
32
GnomAD2 exomes  AF:  0.00000398  AC: 1AN: 251446 AF XY:  0.00000736   show subpopulations 
GnomAD2 exomes 
 AF: 
AC: 
1
AN: 
251446
 AF XY: 
Gnomad AFR exome 
 AF: 
Gnomad AMR exome 
 AF: 
Gnomad ASJ exome 
 AF: 
Gnomad EAS exome 
 AF: 
Gnomad FIN exome 
 AF: 
Gnomad NFE exome 
 AF: 
Gnomad OTH exome 
 AF: 
GnomAD4 exome  AF:  0.00000137  AC: 2AN: 1461784Hom.:  0  Cov.: 32 AF XY:  0.00000138  AC XY: 1AN XY: 727204 show subpopulations  ⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5. 
GnomAD4 exome 
 AF: 
AC: 
2
AN: 
1461784
Hom.: 
Cov.: 
32
 AF XY: 
AC XY: 
1
AN XY: 
727204
show subpopulations 
 ⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5. 
African (AFR) 
 AF: 
AC: 
0
AN: 
33478
American (AMR) 
 AF: 
AC: 
0
AN: 
44724
Ashkenazi Jewish (ASJ) 
 AF: 
AC: 
0
AN: 
26136
East Asian (EAS) 
 AF: 
AC: 
0
AN: 
39700
South Asian (SAS) 
 AF: 
AC: 
1
AN: 
86258
European-Finnish (FIN) 
 AF: 
AC: 
0
AN: 
53420
Middle Eastern (MID) 
 AF: 
AC: 
0
AN: 
5766
European-Non Finnish (NFE) 
 AF: 
AC: 
1
AN: 
1111906
Other (OTH) 
 AF: 
AC: 
0
AN: 
60396
 ⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0.000203476), which strongly suggests a high chance of mosaicism in these individuals. 
 Allele Balance Distribution 
 Red line indicates average allele balance 
 Average allele balance: 0.375 
Heterozygous variant carriers
 0 
 0 
 1 
 1 
 2 
 2 
 0.00 
 0.20 
 0.40 
 0.60 
 0.80 
 0.95 
Allele balance
Age Distribution
Exome Het
Variant carriers
 0 
 2 
 4 
 6 
 8 
 10 
 <30 
 30-35 
 35-40 
 40-45 
 45-50 
 50-55 
 55-60 
 60-65 
 65-70 
 70-75 
 75-80 
 >80 
Age
GnomAD4 genome  Cov.: 32 
GnomAD4 genome 
Cov.: 
32
Alfa 
 AF: 
Hom.: 
ExAC 
 AF: 
AC: 
1
ClinVar
Significance: Pathogenic 
Submissions summary: Pathogenic:1 
Revision: no assertion criteria provided
LINK: link 
Submissions by phenotype
Renal tubular dysgenesis    Pathogenic:1 
Sep 01, 2005
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only
- -
Computational scores
Source: 
Name
Calibrated prediction
Score
Prediction
 AlphaMissense 
 Benign 
 BayesDel_addAF 
 Benign 
T 
 BayesDel_noAF 
 Benign 
 DANN 
 Uncertain 
 DEOGEN2 
 Uncertain 
D;T 
 Eigen 
 Uncertain 
 Eigen_PC 
 Benign 
 FATHMM_MKL 
 Pathogenic 
D 
 LIST_S2 
 Benign 
T;T 
 M_CAP 
 Benign 
D 
 MetaRNN 
 Uncertain 
D;D 
 MetaSVM 
 Benign 
T 
 MutationAssessor 
 Uncertain 
M;. 
 PhyloP100 
 PrimateAI 
 Benign 
T 
 PROVEAN 
 Uncertain 
D;. 
 REVEL 
 Benign 
 Sift 
 Uncertain 
D;. 
 Sift4G 
 Uncertain 
D;. 
 Polyphen 
P;. 
 Vest4 
 MutPred 
Gain of ubiquitination at R230 (P = 0.009);.;
 MVP 
 MPC 
 ClinPred 
D 
 GERP RS 
 Varity_R 
 gMVP 
Splicing
Name
Calibrated prediction
Score
Prediction
 dbscSNV1_ADA 
 Pathogenic 
 dbscSNV1_RF 
 Pathogenic 
 SpliceAI score (max) 
Details are displayed if max score is > 0.2
 DS_DG_spliceai 
Position offset: -27
 DS_DL_spliceai 
Position offset: 0
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at 
Publications
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