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Its etiology is mostly multifactorial, although monogenetic causes of hypercalciuria have also been described. Despite the increased availability of genetic diagnostic tests, the vast majority of individuals with familial hypercalciuria remain unsolved. In this study, we investigated a consanguineous pedigree with idiopathic hypercalciuria. The proband additionally exhibited severe skeletal deformities and hyperparathyroidism. Whole-exome sequencing of the proband revealed a homozygous ultra-rare variant in <jats:italic>TRPV5<\/jats:italic> (NM_019841.7:c.1792G&gt;A; p.(Val598Met)), which encodes for a renal Ca<jats:sup>2+<\/jats:sup>-selective ion channel. The variant segregates with the three individuals with hypercalciuria. The skeletal phenotype unique to the proband was due to an additional pathogenic somatic mutation in <jats:italic>GNAS<\/jats:italic> (NM_000516.7:c.601C&gt;T; p.(Arg201Cys)), which leads to polyostotic fibrous dysplasia. The variant in <jats:italic>TRPV5<\/jats:italic> is located in the TRP helix, a characteristic amphipathic helix that is indispensable for the gating movements of TRP channels. Biochemical characterization of the TRPV5 p.(Val598Met) channel revealed a complete loss of Ca<jats:sup>2+<\/jats:sup> transport capability. This defect is caused by reduced expression of the mutant channel, due to misfolding and preferential targeting to the proteasome for degradation. Based on these findings, we conclude that biallelic loss of <jats:italic>TRPV5<\/jats:italic> function causes a novel form of monogenic autosomal recessive hypercalciuria, which we name renal Ca<jats:sup>2+<\/jats:sup>-wasting hypercalciuria (RCWH). The recessive inheritance pattern explains the rarity of RCWH and underscores the potential prevalence of RCWH in highly consanguineous populations, emphasizing the importance of exploration of this disorder within such communities.<\/jats:p>","DOI":"10.1038\/s41431-024-01589-9","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T09:02:23Z","timestamp":1711357343000},"page":"1506-1514","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Decreased calcium permeability caused by biallelic TRPV5 mutation leads to autosomal recessive renal calcium-wasting hypercalciuria"],"prefix":"10.1038","volume":"32","author":[{"given":"Naz","family":"Guleray Lafci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"van Goor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semra","family":"Cetinkaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"van der Wijst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melisa","family":"Acun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8777-8100","authenticated-orcid":false,"given":"Fatma","family":"Kurt Colak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3528-9495","authenticated-orcid":false,"given":"Arda","family":"Cetinkaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1816-8544","authenticated-orcid":false,"given":"Joost","family":"Hoenderop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"1589_CR1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/BF00442743","volume":"143","author":"K Kruse","year":"1984","unstructured":"Kruse K, Kracht U, Kruse U. 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The study was conducted in accordance with the Declaration of Helsinki and written informed consent including publication of individual details was obtained from all participants and\/or their parents. Additionally, written informed consent for publication of medical images was obtained for the proband.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}