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medRxiv PreprintsInternational30 October 2026

The frameshifted VNTR length determines the kidney survival in ADTKD-MUC1

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Introduction: Autosomal dominant tubulointerstitial kidney disease due to MUC1 variants (ADTKD-MUC1) is caused by pathogenic variants leading to a frameshift in the MUC1 gene, most often because of the duplication of a cytosine in a 7-cytosine stretch within the coding variable number tandem repeat (VNTR). It has been regarded as genotypically uniform despite marked clinical heterogeneity. However, as the duplication can arise in any repeat unit, the length of the toxic MUC1-frameshift protein (MUC1-fs) may differ substantially between patients. We thus hypothesised that MUC1-fs length may det
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