CLINICAL CAPABILITIES // Genetic testing

Renal & Urinary Oncology

Test for genes commonly associated with renal and urinary cancers. 

Clinical at Psomagen

Who Would Benefit from Renal and Urinary Oncology Genetic Testing?

1

A person with a strong family history of certain types of cancer

Determine if they carry a gene mutation that increases their risk. If they do have an inherited mutation, they might want to have screening tests to look for cancer early, or even take steps to try to lower their risk.

2

A person already diagnosed with cancer

This is especially true if there are other factors to suggest the cancer might have been caused by an inherited mutation (such as a strong family history, or if the cancer was diagnosed at a young age). Genetic testing might show if the person has a higher risk of developing cancer. It can also help other family members decide if they want to be tested for the mutation.  

3

Family members of a person known to have an inherited gene mutation that increases their risk of cancer

Testing can help them know if they need screening tests to look for cancer early, or if they should take steps to try to lower their risk.

How Do I Order a Test?

A printed copy of the requisition form must be submitted with the specimen if you are not placing your order through the online portal. You can find and print a copy of the requisition form here. If you need to modify your order, please contact client services.

Renal & Urology Cancer Panel Best Practices

Preferred Specimen

2mL whole blood in a purple-top EDTA tube (K2EDTA or K3EDTA)

Alternate Specimens

  • Saliva
  • Buccal swab
  • gDNA
Let's get started!

How to Ship Your Samples

Follow IATA Regulations

Please note that Psomagen sample collection kits are built to protect the samples from being damaged during transport and to comply with the International Air Transport Association (IATA) regulation. If you are using packaging other than that provided by Psomagen, please make sure to follow the "three layers of packaging" rule to avoid the risk of having the package destroyed by the courier:

  • A primary sample receptacle sealed (collection tube).
  • A leak-proof specimen bag containing absorbent material.
  • An outer packaging that meets the local postal regulations and is labeled as “Exempt Human Specimen.”

For more information please refer to page 187 of IATA Dangerous Goods Regulation.

Additional Shipment Requirements

For saliva, ship at room temperature (overnight shipping is not necessary).

For blood, we recommend using overnight shipping the same day that the blood is collected.

  • Blood can be kept at room temperature for up to 48 hours.
  • We request that blood is refrigerated no longer than two weeks.
  • Please do not freeze blood as deletion/duplication analysis is not supported for frozen or partially frozen blood.

Please ship the specimen in a crush-proof container via FedEx Priority Overnight (in accordance with the FedEx Packaging Guidelines for Clinical Samples.

Our US Shipping Address

Attn: Clinical Laboratory Testing Personnel
Psomagen Inc.
1330 Piccard Drive, Ste 103
Rockville, MD 20850

Test for 28 cancer-related genes

Renal & Oncology Panel Genes

BAP1
CDC73
CDKN1C
DICER1
DIS3L2
EPCAM
FH
FLCN
GPC3
MET
MITF
MLH1
MSH2
MSH6
MUTYH
PMS2
PTEN
SDHA
SDHB
SDHC
SDHD
SMARCA4
SMARCB1
TP53
TSC1
TSC2
VHL
WT1
 

Test Methodology and Limitations

DNA sequencing involves the extraction of genomic DNA from specimens collected in approved containers and provided the specimen meets required sample minimum quantity (e.g. volume, weight, etc). This is followed by quantification and qualification to ensure the adequacy of amount and purity for sequencing. Subsequently, whole exome sequencing is conducted on an IlluminaTM short read sequencing (SRS) platform (e.g., NovaSeq X PlusTM) at Psomagen, Inc.’s laboratories (CLIA # 21D2062464, CAP # 8742212).

DNA sequence alignment, variant calling, and variant filtering are performed utilizing the Illumina DRAGENTM bioinformatics pipeline (version 4.2.4.) and various tool sets, which align reads to the human reference genome (GRCh38) and identify single nucleotide variants (SNVs) and small insertions/deletions (InDels). Variant annotations are performed using a pipeline available in Fabric Enterprise. Variant review and interpretation are conducted according to the standards and guidelines set forth by the American College of Medical Genetics and Genomics (Richards S, et al., Genet Med., 2015) by Fabric Clinical Labs (CLIA #45D2281059, CAP # 9619501). Only variants classified as pathogenic or likely pathogenic are reported. The following quality filters are applied to all variants: coverage <40x, allele balance outside 0.3-0.7. Variants in the following genes are reported: BAP1, CDC73, CDKN1C, DICER1, DIS3L2, EPCAM, FH, FLCN, GPC3, MET, MITF, MLH1, MSH2, MSH6, MUTYH, PMS2, PTEN, SDHA, SDHB, SDHC, SDHD, SMARCA4, SMARCB1, TP53, TSC1, TSC2, VHL, WT1.

This test is designed to detect single nucleotide variants (SNVs) and small insertions/deletions (indels). Next-Generation Sequencing (NGS) coverage may vary across the genome, potentially resulting in missed variants in regions with low coverage depth. Some genetic abnormalities may be undetectable with the current version of this test. While the DRAGEN bioinformatics pipeline demonstrates high accuracy for variant calling, there remains a possibility of false positive or false negative results due to variant interpretation which relies on current scientific knowledge and available databases. This may lead to the reclassification of reported variants as new information emerges from ongoing research and is updated in the ACMG guidelines. Furthermore, systematic chemical, computational, or human errors may contribute to false positives or false negatives of DNA variants. For any reported variants, confirmation by orthogonal technology and subsequent consultation with a genetic counselor or qualified healthcare provider can help to establish definitive risk. This result should be considered preliminary until such confirmation has been performed.

Clinical management for this individual should be based on personal and family history, along with other relevant information. If considered relevant to this individual’s clinical presentation and/or family history, targeted testing of appropriate family members of this individual for the reported variants may help to interpret these results. For assistance with the interpretation of these results, healthcare professionals may contact Psomagen directly at (301) 251-1007 or support@psomagen.com.

More Resources

  1. United States Renal Data System : 2021 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, Bethesda, MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2021 [Google Scholar]

  2. Freedman BI, Soucie JM, McClellan WM: Family history of end-stage renal disease among incident dialysis patientsJ Am Soc Nephrol8: 1942–1945, 1997. 10.1681/ASN.V8121942 [PubMed] [CrossRef[Google Scholar]

  3. Freedman BI, Volkova NV, Satko SG, Krisher J, Jurkovitz C, Soucie JM, McClellan WM: Population-based screening for family history of end-stage renal disease among incident dialysis patientsAm J Nephrol25: 529–535, 2005. 10.1159/000088491 [PubMed] [CrossRef[Google Scholar]

  4. McClellan WM, Satko SG, Gladstone E, Krisher JO, Narva AS, Freedman BI: Individuals with a family history of ESRD are a high-risk population for CKD: Implications for targeted surveillance and intervention activitiesAm J Kidney Dis53: S100–S106, 2009. 10.1053/j.ajkd.2008.07.059 [PubMed] [CrossRef[Google Scholar]

  5. Connaughton DM, Bukhari S, Conlon P, Cassidy E, O’Toole M, Mohamad M, Flanagan J, Butler T, O’Leary A, Wong L, O’Regan J, Moran S, O’Kelly P, Logan V, Griffin B, Griffin M, Lavin P, Little MA, Conlon P: The Irish Kidney Gene Project—Prevalence of family history in patients with kidney disease in IrelandNephron130: 293–301, 2015. 10.1159/000436983 [PubMed] [CrossRef[Google Scholar]

  6. Connaughton DM, Kennedy C, Shril S, Mann N, Murray SL, Williams PA, Conlon E, Nakayama M, van der Ven AT, Ityel H, Kause F, Kolvenbach CM, Dai R, Vivante A, Braun DA, Schneider R, Kitzler TM, Moloney B, Moran CP, Smyth JS, Kennedy A, Benson K, Stapleton C, Denton M, Magee C, O’Seaghdha CM, Plant WD, Griffin MD, Awan A, Sweeney C, Mane SM, Lifton RP, Griffin B, Leavey S, Casserly L, de Freitas DG, Holian J, Dorman A, Doyle B, Lavin PJ, Little MA, Conlon PJ, Hildebrandt F: Monogenic causes of chronic kidney disease in adultsKidney Int95: 914–928, 2019. 10.1016/j.kint.2018.10.031 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  7. Mallett A, Fowles LF, McGaughran J, Healy H, Patel C: A multidisciplinary renal genetics clinic improves patient diagnosisMed J Aust204: 58–59, 2016. 10.5694/mja15.01157 [PubMed] [CrossRef[Google Scholar]

  8. Mallett AJ, McCarthy HJ, Ho G, Holman K, Farnsworth E, Patel C, Fletcher JT, Mallawaarachchi A, Quinlan C, Bennetts B, Alexander SI: Massively parallel sequencing and targeted exomes in familial kidney disease can diagnose underlying genetic disordersKidney Int92: 1493–1506, 2017. 10.1016/j.kint.2017.06.013 [PubMed] [CrossRef[Google Scholar]

  9. Groopman EE, Marasa M, Cameron-Christie S, Petrovski S, Aggarwal VS, Milo-Rasouly H, Li Y, Zhang J, Nestor J, Krithivasan P, Lam WY, Mitrotti A, Piva S, Kil BH, Chatterjee D, Reingold R, Bradbury D, DiVecchia M, Snyder H, Mu X, Mehl K, Balderes O, Fasel DA, Weng C, Radhakrishnan J, Canetta P, Appel GB, Bomback AS, Ahn W, Uy NS, Alam S, Cohen DJ, Crew RJ, Dube GK, Rao MK, Kamalakaran S, Copeland B, Ren Z, Bridgers J, Malone CD, Mebane CM, Dagaonkar N, Fellström BC, Haefliger C, Mohan S, Sanna-Cherchi S, Kiryluk K, Fleckner J, March R, Platt A, Goldstein DB, Gharavi AG: Diagnostic utility of exome sequencing for kidney diseaseN Engl J Med380: 142–151, 2019. 10.1056/NEJMoa1806891 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  10. Lata S, Marasa M, Li Y, Fasel DA, Groopman E, Jobanputra V, Rasouly H, Mitrotti A, Westland R, Verbitsky M, Nestor J, Slater LM, D’Agati V, Zaniew M, Materna-Kiryluk A, Lugani F, Caridi G, Rampoldi L, Mattoo A, Newton CA, Rao MK, Radhakrishnan J, Ahn W, Canetta PA, Bomback AS, Appel GB, Antignac C, Markowitz GS, Garcia CK, Kiryluk K, Sanna-Cherchi S, Gharavi AG: Whole-exome sequencing in adults with chronic kidney disease: A pilot studyAnn Intern Med168: 100–109, 2018. 10.7326/M17-1319 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  11. Mallett A, Patel C, Salisbury A, Wang Z, Healy H, Hoy W: The prevalence and epidemiology of genetic renal disease amongst adults with chronic kidney disease in AustraliaOrphanet J Rare Dis9: 98, 2014. 10.1186/1750-1172-9-98 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  12. Gribouval O, Boyer O, Hummel A, Dantal J, Martinez F, Sberro-Soussan R, Etienne I, Chauveau D, Delahousse M, Lionet A, Allard J, Pouteil Noble C, Tête MJ, Heidet L, Antignac C, Servais A: Identification of genetic causes for sporadic steroid-resistant nephrotic syndrome in adultsKidney Int94: 1013–1022, 2018. 10.1016/j.kint.2018.07.024 [PubMed] [CrossRef[Google Scholar]

  13. Lovric S, Ashraf S, Tan W, Hildebrandt F: Genetic testing in steroid-resistant nephrotic syndrome: When and how?Nephrol Dial Transplant 31: 1802–1813, 2016. 10.1093/ndt/gfv355 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  14. Gast C, Pengelly RJ, Lyon M, Bunyan DJ, Seaby EG, Graham N, Venkat-Raman G, Ennis S: Collagen (COL4A) mutations are the most frequent mutations underlying adult focal segmental glomerulosclerosisNephrol Dial Transplant31: 961–970, 2016. 10.1093/ndt/gfv325 [PubMed] [CrossRef[Google Scholar]

  15. Yao T, Udwan K, John R, Rana A, Haghighi A, Xu L, Hack S, Reich HN, Hladunewich MA, Cattran DC, Paterson AD, Pei Y, Barua M: Integration of genetic testing and pathology for the diagnosis of adults with FSGSClin J Am Soc Nephrol14: 213–223, 2019. 10.2215/CJN.08750718 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  16. Daga A, Majmundar AJ, Braun DA, Gee HY, Lawson JA, Shril S, Jobst-Schwan T, Vivante A, Schapiro D, Tan W, Warejko JK, Widmeier E, Nelson CP, Fathy HM, Gucev Z, Soliman NA, Hashmi S, Halbritter J, Halty M, Kari JA, El-Desoky S, Ferguson MA, Somers MJG, Traum AZ, Stein DR, Daouk GH, Rodig NM, Katz A, Hanna C, Schwaderer AL, Sayer JA, Wassner AJ, Mane S, Lifton RP, Milosevic D, Tasic V, Baum MA, Hildebrandt F: Whole exome sequencing frequently detects a monogenic cause in early onset nephrolithiasis and nephrocalcinosisKidney Int93: 204–213, 2018. 10.1016/j.kint.2017.06.025 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  17. Halbritter J, Baum M, Hynes AM, Rice SJ, Thwaites DT, Gucev ZS, Fisher B, Spaneas L, Porath JD, Braun DA, Wassner AJ, Nelson CP, Tasic V, Sayer JA, Hildebrandt F: Fourteen monogenic genes account for 15% of nephrolithiasis/nephrocalcinosisJ Am Soc Nephrol26: 543–551, 2015. 10.1681/ASN.2014040388 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  18. Verbitsky M, Westland R, Perez A, Kiryluk K, Liu Q, Krithivasan P, Mitrotti A, Fasel DA, Batourina E, Sampson MG, Bodria M, Werth M, Kao C, Martino J, Capone VP, Vivante A, Shril S, Kil BH, Marasà M, Zhang JY, Na YJ, Lim TY, Ahram D, Weng PL, Heinzen EL, Carrea A, Piaggio G, Gesualdo L, Manca V, Masnata G, Gigante M, Cusi D, Izzi C, Scolari F, van Wijk JAE, Saraga M, Santoro D, Conti G, Zamboli P, White H, Drozdz D, Zachwieja K, Miklaszewska M, Tkaczyk M, Tomczyk D, Krakowska A, Sikora P, Jarmoliński T, Borszewska-Kornacka MK, Pawluch R, Szczepanska M, Adamczyk P, Mizerska-Wasiak M, Krzemien G, Szmigielska A, Zaniew M, Dobson MG, Darlow JM, Puri P, Barton DE, Furth SL, Warady BA, Gucev Z, Lozanovski VJ, Tasic V, Pisani I, Allegri L, Rodas LM, Campistol JM, Jeanpierre C, Alam S, Casale P, Wong CS, Lin F, Miranda DM, Oliveira EA, Simões-E-Silva AC, Barasch JM, Levy B, Wu N, Hildebrandt F, Ghiggeri GM, Latos-Bielenska A, Materna-Kiryluk A, Zhang F, Hakonarson H, Papaioannou VE, Mendelsohn CL, Gharavi AG, Sanna-Cherchi S: The copy number variation landscape of congenital anomalies of the kidney and urinary tract [published correction appears in Nat Genet51: 764, 2019 10.1038/s41588-019-0376-0]Nat Genet 51: 117–127, 2019. 10.1038/s41588-018-0281-y [PMC free article] [PubMed] [CrossRef[Google Scholar]

  19. Bullich G, Domingo-Gallego A, Vargas I, Ruiz P, Lorente-Grandoso L, Furlano M, Fraga G, Madrid Á, Ariceta G, Borregán M, Piñero-Fernández JA, Rodríguez-Peña L, Ballesta-Martínez MJ, Llano-Rivas I, Meñica MA, Ballarín J, Torrents D, Torra R, Ars E: A kidney-disease gene panel allows a comprehensive genetic diagnosis of cystic and glomerular inherited kidney diseasesKidney Int94: 363–371, 2018. 10.1016/j.kint.2018.02.027 [PubMed] [CrossRef[Google Scholar]

  20. Goodwin S, McPherson JD, McCombie WR: Coming of age: Ten years of next-generation sequencing technologiesNat Rev Genet17: 333–351, 2016. 10.1038/nrg.2016.49 [PMC free article] [PubMed] [CrossRef[Google Scholar]

  21. Groopman EE, Rasouly HM, Gharavi AG: Genomic medicine for kidney diseaseNat Rev Nephrol14: 83–104, 2018. 10.1038/nrneph.2017.167 [PMC free article] [PubMed] [CrossRef[Google Scholar]