Kidney disease: meant-to-be or dumb luck? Part 2 – DNA

DNAOne of the (many) cool and wondrous benefits of being alive in the 21st Century is our ability to look deeply into our own bodies, right down to the very building blocks of life, our DNA, to glimpse our personal program for life.  Another almost-as-amazing benefit is that it costs just $99!

I was keen to check it out to see if my DNA had my kidney failure pre-programmed or if it was just dumb bad luck.

Getting started

I had read quite a bit about 23andMe and had long been keen to see what it had to offer.  So I clicked buy and began my journey.

But first I had to read and confirm the paperwork, and there is plenty of it.  But it was not your usual, “Take it or leave it” small print.

For example, the Family Considerations page is headed What unexpected things might I learn?  It begins: Looking at your genetic data might uncover information that some people find surprising. This information can be relatively benign and even amusing. At other times, the information you learn can have profound implications for both you and your family. 

The Terms of Service has the usual legal guff, but also spells out the risks (Once you obtain your Genetic Information, the knowledge is irrevocable…); it also suggests things to consider and addresses the fear of finding out, which are unique to this service.  The Privacy Statement is similarly beefed up with detail to address the security fears of anyone sharing their most intimate personal information.

The Consent Document was my formal confirmation that I understood what I was signing up for.  I took a deep breath (the first of what turned out to be several as my journey progressed) and clicked Continue.

I’m in!

I registered and purchased a Spit Kit, which arrived a few weeks later.  As instructed, I spat into the tube provided and sent it back to them (post-paid).  A few weeks later an email arrived saying my report was ready and available in my online account.  I logged in and wallah!

23 Home

The HOME page shows a summary of what my DNA says about me, divided into various topics.  The first four the panels displayed ancestry stuff, which is obviously a popular subject – “Where did I come from?”  Since my primary aim was to see if DNA is responsible for my kidney failure, I found the HEALTH OVERVIEW panel and clicked on it and found the motherlode: 263 findings about me, divided into health risks, traits, inherited conditions and drug responses.

23 Health results menu - Copy

 

This is a big area.  All the findings are measured in detail and more detail, with study references, explanations, etc. against a typical/average healthy person’s DNA.  There’s a lot to know, but the trip is absolutely worth it.

For example, under Risks, there were 122 possible risks for me developing certain health conditions based on my genes, or that could be influenced by environmental and lifestyle factors.  The risks were divided into four categories:

23 Health risks 1

23 Health risks 2

23 Health risks 3

Locked Reports is a special category.  For serious stuff like Alzheimer’s, they don’t just show the result, I got a choice as to whether I wanted to know (this knowledge could also affect my family).  Before showing the result, they provide some background (a video) to the test, the disease and the implications of finding out.  After some careful thought, I took (another) deep breath and looked at the result.

The problem DNA combination often present in Alzheimer’s patients NOT present in my DNA.  Phew!

So, was my DNA programmed for kidney failure?

First the Risks

I looked through my 122 Elevated Risks, starting with the 27 highest.  At the top of the list was Type 2 Diabetes 2 (32.6% higher than average).  This definitely can, and often does cause kidney failure.  However, I don’t have Type 2 Diabetes, so no obvious DNA trigger there.  In fact, none of the other 26 elevated risks could be seen as triggering my kidney failure either.  (Though interestingly, my risk for Gout was 30.6% higher and for Restless Legs 2.5% higher.  I have both of these, but they developed after my kidney failure.)

I scanned the 31 Decreased Risks.  None are related to kidney failure, and they are all less than the average person for me anyway.

Finally, I checked out the 63 risks where I rated Typical Risk level: There were four kidney-failure related risks: Chronic kidney disease, Kidney disease, Kidney stones and Kidney cancer, and I was rated typical on all of them.

So on the Risks front, my one identified possible DNA trigger didn’t go off.

Second, Inherited Conditions

Of the 53 possible, the only real candidate was for genetically-related hearing loss.  No kidney failure triggers here. (I can still hear Ok so far.)

Third, Traits

Of the 63 traits, most were pretty accurate though not World-changing (as predicted by my DNA, I do have red hair, wet ear wax, brown eyes, I can smell sweaty people and, surprise, partial resistance to HIV).  But no news on an inbuilt tendency for kidney failure.

Four, Drug Response

Of the 25 responses listed, among others, I have increased sensitivity to Warfarin, a reduced Hepatitis C treatment response, I metabolise caffeine quickly (reducing my heart attack risk) and higher odds of becoming addicted to heroin.  Interesting stuff, but again no news on an inbuilt tendency for kidney failure

The Answer

Based on the latest available DNA tests, there is no evidence that my DNA was programmed for kidney failure.  It was probably just dumb luck.  This is very good news.

While some brilliant new future test may eventually prove otherwise, right now I take great comfort in this result.  Mainly because If it’s not in my DNA, it’s not in my kids’ or their kids’ DNA.

So far that has proved to be the case.

 

ps: A little more about DNA

DNA maps vs Google maps

Until I got to this point, I hadn’t thought that much about the process of DNA analysis.  I suppose I assumed that my DNA map was like a Google map: all my health and ancestry would be laid bare.  But it is of course much more complex.  My DNA map is just that: a huge, detailed, complex picture of my genetic structure.  Finding out what each gene and gene combination means is a whole different kettle of fish.

It’s as if Google served me up a blank city map, showing every place, street, park, building, community and ant hole, but without any annotations, or written information of any kind (in Melbourne that’s 7,673 sq km – 2,962 sq miles of blank map).  The map would be a huge advance on nothing; but it would take years to fill in the names of places, streets and ant holes before it became useful.

That’s where scientists found themselves in April 2003 when the entire human genome was mapped.  Adding meaning to the map is of course hugely more complex than our blank Google map, and is still very much a work in progress.  Mostly they do it by working backwards: mapping the DNA of groups of people with various health problems, traits, inherited conditions, drug responses, etc and comparing their maps with people without those things.  The genes that vary in some way might then have some role in causing or triggering the problem.

23andMe collected and continues to collect new parts of the map from reputable studies around the world.  They also do their own studies via member questions and surveys on topics like migraines, asthma, stress, vocabulary, reactions to specific drugs, family longevity, etc.  They then match their findings at a DNA level, look for trends, and fill in a little more of the map.

pps: DNA Ancestry. 

The 23andMe ancestry stuff is even more amazing than the health stuff.  Instead of comparing DNA details, they link millions of archaeological DNA details and findings to create our personalised DNA family history.

It’s a real page-turner (after all, what can be more fascinating than the thousands year history of you and me?)

 

 

 

5 thoughts on “Kidney disease: meant-to-be or dumb luck? Part 2 – DNA

  1. This was fascinating. I followed the link to the website and it says that it costs $199. Was there a special going on, or did you have a discount coupon so that it cost $99? Thank you.

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      • Oh great, that link does say $99. I know my PKD was inherited. And there is Alzheimer’s in my family. It’s a lot to think about, not sure I would have the willpower to resist looking at the locked results and yet I don’t know if I want to know if I have the gene for that too. I’ll have to think about it. Very tempting though.

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  2. Quite fascinating but as you say it is a blank map until some of the better brains can tag each gene with its purpose. A starting point is surely the definitions that our clever researchers have already established

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    • Hi Robert. Absolutely they do use the world’s DNA research, and they continue to do so. In fact, I have received updates to my DNA report each time something new is discovered, for at least the last few years (no extra charge). The most memorable one was when researchers discovered that most of us have some Neanderthal DNA! I even bought the T-shirt!
      Regards, Greg

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