RenalNext®

RenalNext is a next generation sequencing panel that simultaneously analyzes 20 genes associated with increased risk for kidney cancer.
Quick Reference
Test Code 5900
Turnaround Time (TAT) 14-21 days
Number of Genes 20

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Ordering Options

We offer family variant testing at no additional cost

for all blood relatives of patients who undergo full single gene sequencing, multigene panel testing or exome sequencing at Ambry Genetics and are found to have a pathogenic or likely pathogenic variant. No-cost testing of blood relatives must be completed within 90 days of the original report date. Whenever possible, more closely related relatives should be tested before more distant relatives.

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Why Is This Important?

  1. Option to modify frequency and initial age of cancer screening, as appropriate
  2. Consideration of risk-reducing measures, as appropriate 
  3. Identify at-risk family members 

When To Consider Testing

  • Early-onset kidney cancer (diagnosed <46 years of age)
  • Multiple primary cancers in one person (e.g. 2 primary kidney cancers or kidney and thyroid cancer)
  • >2 family members* with kidney cancer OR >3 family members* with kidney and other cancers
  • Multiple close family members* with kidney and neuroendocrine tumors

  * On the same side of the family

Mutation Detection Rate

RenalNext can detect >99.9% of described mutations in the included genes, when present (analytic sensitivity).

Test Description

RenalNext analyzes 20 genes (listed above). These genes (excluding EPCAM) are evaluated by next generation sequencing (NGS) or Sanger sequencing of all coding domains, and well into the flanking 5’ and 3’ ends of all the introns and untranslated regions. For MITF, only the status of the c.952G>A (p.E318K) alteration is analyzed and reported. The inversion of coding exons 1-7 of the MSH2 gene is detected by NGS and confirmed by MLPA. Clinically significant intronic findings beyond 5 base pairs are always reported. Intronic variants of unknown or unlikely clinical significance are not reported beyond 5 base pairs from the splice junction. Additional Sanger sequencing is performed for any regions missing or with insufficient read depth coverage for reliable heterozygous variant detection. Potentially homozygous variants, variants in regions complicated by pseudogene interference, and variant calls not satisfying depth of coverage and variant allele frequency quality thresholds are verified by Sanger sequencing. Gross deletion/duplication analysis is performed for the covered exons and untranslated regions of all sequenced genes (excluding MITF) using read-depth from NGS data with confirmatory multiplex ligation-dependent probe amplification (MLPA) and/or targeted chromosomal microarray. For EPCAM, only gross deletions encompassing the 3’ end of the gene are reported.  For PMS2, gross deletion/duplication analysis is performed using MLPA. If a deletion is detected in exons 13, 14, or 15 of PMS2, double stranded sequencing of the appropriate exon(s) of the pseudogene, PMS2CL, will be performed to determine if the deletion is located in the PMS2 gene or pseudogene. 

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