ACTN4

Summary

ACTN4 (actinin alpha 4, HGNC:166) is a protein-coding gene on chromosome 19q13.2, encoding Alpha-actinin-4 (O43707). F-actin cross-linking protein which is thought to anchor actin to a variety of intracellular structures.

Alpha actinins belong to the spectrin gene superfamily which represents a diverse group of cytoskeletal proteins, including the alpha and beta spectrins and dystrophins. Alpha actinin is an actin-binding protein with multiple roles in different cell types. In nonmuscle cells, the cytoskeletal isoform is found along microfilament bundles and adherens-type junctions, where it is involved in binding actin to the membrane. In contrast, skeletal, cardiac, and smooth muscle isoforms are localized to the Z-disc and analogous dense bodies, where they help anchor the myofibrillar actin filaments. This gene encodes a nonmuscle, alpha actinin isoform which is concentrated in the cytoplasm, and thought to be involved in metastatic processes. Mutations in this gene have been associated with focal and segmental glomerulosclerosis.

Source: NCBI Gene 81 — RefSeq curated summary.

At a glance

• Gene–disease (curated): focal segmental glomerulosclerosis 1 (Strong, GenCC) — +1 more curated relationship
• GWAS associations: 9
• Clinical variants (ClinVar): 596 total — 6 pathogenic, 11 likely-pathogenic
• Phenotypes (HPO): 27
• Druggable target: yes — 1 molecules with ChEMBL bioactivity
• MANE Select transcript: NM_004924

Identifiers

Gene identifiers

Field	Value
HGNC ID	HGNC:166
Approved symbol	ACTN4
Name	actinin alpha 4
Location	19q13.2
Locus type	gene with protein product
Status	Approved
Ensembl gene	ENSG00000130402
Ensembl biotype	protein_coding
OMIM	604638
Entrez	81

Gene structure

Transcript identifiers

Ensembl transcripts: 29 — 24 protein_coding, 4 retained_intron, 1 protein_coding_CDS_not_defined

ENST00000252699, ENST00000390009, ENST00000424234, ENST00000440400, ENST00000477174, ENST00000489451, ENST00000495553, ENST00000497637, ENST00000588618, ENST00000589528, ENST00000697712, ENST00000871324, ENST00000871325, ENST00000871326, ENST00000871327, ENST00000871328, ENST00000871329, ENST00000871330, ENST00000871331, ENST00000871332, ENST00000871333, ENST00000871334, ENST00000871335, ENST00000871336, ENST00000871337, ENST00000924368, ENST00000924369, ENST00000924370, ENST00000924371

RefSeq mRNA: 3 — MANE Select: NM_004924 NM_001322033, NM_001411143, NM_004924

CCDS: CCDS12518, CCDS92610, CCDS92611

Canonical transcript exons

ENST00000252699 — 21 exons

Exon	Start	End
ENSE00000895774	38727946	38728026
ENSE00000895777	38724431	38724565
ENSE00000895778	38724157	38724339
ENSE00000895779	38723937	38724077
ENSE00000895780	38723614	38723722
ENSE00000895781	38721538	38721688
ENSE00001909908	38647649	38647907
ENSE00002256794	38725724	38725903
ENSE00002529868	38726957	38727103
ENSE00003478716	38708117	38708195
ENSE00003521050	38717927	38718074
ENSE00003542253	38701002	38701121
ENSE00003563841	38709395	38709476
ENSE00003590443	38706044	38706131
ENSE00003605223	38700600	38700714
ENSE00003612741	38710257	38710342
ENSE00003616079	38728996	38729154
ENSE00003622921	38714469	38714561
ENSE00003628896	38704934	38705020
ENSE00003790855	38717086	38717316
ENSE00003842835	38729274	38731589

Expression profiles

Bgee: expression breadth ubiquitous, 145 present calls, max score 99.48.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 97.8361 / max 1000.0509, expressed in 1827 samples.

FANTOM5 promoters (4 alternative TSS)

Promoter ID	TPM avg	Samples expressed
175645	59.6754	1824
175646	37.4462	1803
175650	0.6088	365
175654	0.1057	47

Top tissues by expression

145 total, by Bgee expression score (0-100, higher = more expressed):

Tissue	Anatomy ID	Expression score	Quality
popliteal artery	UBERON:0002250	99.48	gold quality
tibial artery	UBERON:0007610	99.48	gold quality
smooth muscle tissue	UBERON:0001135	99.43	gold quality
right coronary artery	UBERON:0001625	99.43	gold quality
artery	UBERON:0001637	99.43	gold quality
aorta	UBERON:0000947	99.41	gold quality
stromal cell of endometrium	CL:0002255	99.39	gold quality
ascending aorta	UBERON:0001496	99.33	gold quality
thoracic aorta	UBERON:0001515	99.32	gold quality
placenta	UBERON:0001987	99.30	gold quality
body of uterus	UBERON:0009853	99.27	gold quality
islet of Langerhans	UBERON:0000006	99.26	gold quality
myometrium	UBERON:0001296	99.18	gold quality
lower esophagus mucosa	UBERON:0035834	99.11	gold quality
descending thoracic aorta	UBERON:0002345	99.07	gold quality
left coronary artery	UBERON:0001626	99.04	gold quality
duodenum	UBERON:0002114	99.04	gold quality
fallopian tube	UBERON:0003889	98.99	gold quality
vermiform appendix	UBERON:0001154	98.96	gold quality
esophagus mucosa	UBERON:0002469	98.96	gold quality
metanephros cortex	UBERON:0010533	98.95	gold quality
vagina	UBERON:0000996	98.94	gold quality
left uterine tube	UBERON:0001303	98.94	gold quality
ectocervix	UBERON:0012249	98.94	gold quality
right lung	UBERON:0002167	98.91	gold quality
skin of leg	UBERON:0001511	98.90	gold quality
upper lobe of left lung	UBERON:0008952	98.90	gold quality
esophagus	UBERON:0001043	98.88	gold quality
transverse colon	UBERON:0001157	98.88	gold quality
rectum	UBERON:0001052	98.86	gold quality

Single-cell (SCXA)

Detected in 6 experiment(s), a significant marker in 5.

Experiment	Marker?	Max mean expression
E-HCAD-11	yes	18.97
E-HCAD-10	yes	18.91
E-HCAD-13	yes	7.47
E-GEOD-137537	yes	6.11
E-CURD-112	no	2.51
E-ANND-3	no	0.00

Regulation

Is transcription factor: no

Upstream regulators (CollecTRI, top): HDAC7

miRNA regulators (miRDB)

125 targeting ACTN4, top 30 by miRDB confidence (max_score; target_count = how many genes the miRNA targets in total — lower means more specific):

miRNA	Max score	Avg score	miRNA target_count
HSA-MIR-3613-3P	100.00	76.36	7965
HSA-MIR-5011-5P	100.00	83.46	5820
HSA-MIR-190A-3P	100.00	80.35	5520
HSA-MIR-4692	100.00	67.32	2066
HSA-MIR-5692B	100.00	71.32	2622
HSA-MIR-5692C	100.00	71.32	2622
HSA-MIR-6758-5P	100.00	66.21	1470
HSA-MIR-6856-5P	100.00	65.47	1298
HSA-MIR-371B-5P	99.99	75.34	4759
HSA-MIR-548C-3P	99.99	74.01	7587
HSA-MIR-4514	99.99	67.10	1870
HSA-MIR-373-5P	99.98	75.36	4753
HSA-MIR-616-5P	99.98	75.58	4775
HSA-MIR-6825-5P	99.96	69.81	3431
HSA-MIR-559	99.95	72.28	3609
HSA-MIR-548AB	99.95	71.31	3488
HSA-MIR-185-3P	99.95	67.01	1743
HSA-MIR-548A-5P	99.94	71.27	3482
HSA-MIR-548AD-5P	99.94	71.23	3502
HSA-MIR-548AE-5P	99.94	71.23	3502
HSA-MIR-548AK	99.94	71.24	3488
HSA-MIR-548AM-5P	99.94	71.24	3488
HSA-MIR-548AP-5P	99.94	71.14	3489
HSA-MIR-548AQ-5P	99.94	71.34	3426
HSA-MIR-548AR-5P	99.94	71.28	3515
HSA-MIR-548AS-5P	99.94	71.22	3482
HSA-MIR-548AU-5P	99.94	71.24	3488
HSA-MIR-548AY-5P	99.94	71.23	3502
HSA-MIR-548B-5P	99.94	71.23	3502
HSA-MIR-548BB-5P	99.94	71.27	3509

Literature-anchored findings (GeneRIF, showing 40)

• interaction with tight junction protein MAGI-1 (PMID:12042308)
• isolated two anti-alpha-actinin-4 T cell clones from the same patient TIL and from his peripheral blood lymphocytes (PBLs) by using tetramers of soluble HLA-A2 molecules loaded with the mutated peptide (PMID:12093915)
• Sporadic FSGS is a heterogeneous disease, since ACTN4 and podocin genes are not found in our patients with sporadic FSGS. (PMID:12617336)
• ACTN4 has a role promoting tumorigenicity and regulating cell motility (PMID:15048094)
• Actinin alpha-4 is mainly present intracellularly and is involved in cellular motility via interaction with the actin cytoskeleton, thus probably affecting the metastatic potential of tumor cells. (PMID:15493875)
• Results suggest that humanin is a novel binding partner of the alpha-actinin-4 R1-R4 domain in podocytes. (PMID:15619032)
• the endosome-associated protein hrs is a subunit of a protein complex containing actinin-4, BERP, and myosin V that is necessary for efficient TfR recycling but not for EGFR degradation (PMID:15772161)
• No mutations detected in Japanese congenital nephrotic synddrome patients. (PMID:15780077)
• ACTN4 mutations accounts for about 3.5% of familial focal glomerulosclerosis. (PMID:16251236)
• Interaction of alpha 4 actinin with ICAM-1 is required for leukocyte extravasation. (PMID:16951376)
• The role of ACTN4 in MEF2A transcription via HDAC7 antagonism is reported. (PMID:16980305)
• A critical regulator of AKT1 localization and function. (PMID:17018644)
• Cytokine activation of MAPK14 and apoptosis is opposed by ACTN4 targeting of protein phosphatase 2A for site-specific dephosphorylation of MEK3. (PMID:17438131)
• actinin-4…could be a novel prognostic indicator for patients with ovarian carcinomas. (PMID:17873890)
• exposure of a buried actin-binding site 1 in mutant alpha-actinin-4 causes an increase in its actin-binding affinity (PMID:17901210)
• common variants in LRRC7, KIRREL, NPHS2 and ACTN4 do not appeear to contribute to susceptibility to diabetic nephropathy in Finnish patients with type 1 diabetes (PMID:17968527)
• Crystal structure of the actin-binding domain of alpha-actininin-4 Lys255Glu mutant implicated in focal segmental glomerulosclerosis. (PMID:18164029)
• eNOS activity in vascular endothelial cells is tonically and dynamically regulated by competitive interaction with alpha-actinin-4 and calmodulin. (PMID:18180332)
• alpha-actinin-4 is important for the NF-kappaB nuclear translocation and its functions inside the nucleus. (PMID:18215660)
• Motility-related ACTN4 is associated with advanced and metastatic ovarian carcinoma. (PMID:18362906)
• A novel ACTN4 mutation, p.Ser262Phe, was detected in the patients, and their father was found to have a germline mosaicism for the mutation in these patients with familial focal segmental glomerulosclerosis (PMID:18436095)
• low expression levels of alpha-actinin-4 mRNA and protein are linked to the progression of glomerulopathy and proteinuria in human diabetic nephropathy (PMID:18552466)
• Actinin-4 contributes to the invasive growth of pancreatic ductal carcinoma, and ACTN4 is one of the candidate oncogenes in this chromosome locus. (PMID:18765526)
• Mutations and single nucleotide polymorphisms of the ACTN4 gene may be associated with Chinese idiopathic focal segmental glomerulosclerosis. (PMID:19142020)
• The actinin-4 gene may serve as a predictor of poor outcome and tumor chemoresistance in patients with advanced-stage ovarian cancers. (PMID:19151661)
• Mutations in ACTN4, the gene encoding the actin-binding protein alpha-actinin-4, are a cause of focal segmental glomerulosclerosis. (PMID:19357256)
• Heterozygous mutations in the promoters of the ACTN4 and SYNPO genes are found in patients with idiopathic focal segmental glomerulosclerosis. (PMID:19666657)
• Data show that actinin-4 expression levels significantly correlate with worse survival after PDAC resection. (PMID:19672209)
• expression of alpha-actinin-4 was significantly associated with invasion potential defined by the Matrigel invasion assay. Cancer cell lines with higher alpha-actinin-4 expression had greater invasive potential. (PMID:19913389)
• EGF regulates the actin binding activity of ACTN4 by inducing tyrosyl-directed phosphorylation (PMID:19920151)
• The absence of mutations of ACTN4 in this study suggests that there are other genetic causes of steroid-resistant nephrotic syndrome (PMID:19956976)
• Both alpha-actinin-1 and alpha-actinin-4 make critical and distinct contributions to cytoskeletal organization, rigidity-sensing, and motility of glioma cells. (PMID:20037648)
• Alpha-actinin 1 and 4 are differentially regulated during the development and progression of astrocytomas because each of these isoforms uniquely contributes to distinct malignant properties of astrocytoma cells. (PMID:20156433)
• The association of ACTN4 with different ribonucleoproteins suggests that a major function of nuclear ACTN4 may be regulation of mRNA metabolism and signaling. (PMID:20519146)
• Levels of eEF1A2 and alpha-actinin-4 mRNA appeared to be unrelated to breast tumour size, except for a significant down-regulation of alpha-actinin-4 mRNA in T3 cases. (PMID:20819441)
• The actin-binding protein, actinin alpha 4 (ACTN4), is a nuclear receptor coactivator that promotes proliferation of MCF-7 breast cancer cells. (PMID:21078666)
• Epothilone B antagonizes glioma cell motility associated with reorganization of the actin-binding protein alpha-actinin 4. (PMID:21234524)
• The results suggest that the interaction between HAMLET and alpha-actinins promotes tumor cell detachment. (PMID:21408150)
• The urinary mRNA profiles of synaptopodin, podocalyxin, CD2-AP, alpha-actin4, and podocin were found to increase with the progression of diabetic nephropathy. (PMID:21655212)
• Alpha-actinin-4 and CLP36 protein deficiencies contribute to podocyte defects in multiple human glomerulopathies (PMID:21680739)

Cross-species orthologs

2 orthologs

Organism	Symbol	Gene ID
mus_musculus	Actn4	ENSMUSG00000054808
rattus_norvegicus	Actn4	ENSRNOG00000020433

Paralogs (36): SYNE2 (ENSG00000054654), SPTB (ENSG00000070182), ACTN1 (ENSG00000072110), ACTN2 (ENSG00000077522), DSP (ENSG00000096696), DRP2 (ENSG00000102385), SPTBN1 (ENSG00000115306), MACF1 (ENSG00000127603), FLNC (ENSG00000128591), SYNE1 (ENSG00000131018), MICAL2 (ENSG00000133816), DTNA (ENSG00000134769), MICAL1 (ENSG00000135596), FLNB (ENSG00000136068), SPTBN5 (ENSG00000137877), DTNB (ENSG00000138101), GAS2L3 (ENSG00000139354), DST (ENSG00000151914), UTRN (ENSG00000152818), SPTBN4 (ENSG00000160460), SPTA1 (ENSG00000163554), CLMN (ENSG00000165959), PKHD1 (ENSG00000170927), SPTBN2 (ENSG00000173898), SYNE3 (ENSG00000176438), PLEC (ENSG00000178209), SMTNL2 (ENSG00000188176), FLNA (ENSG00000196924), SPTAN1 (ENSG00000197694), DMD (ENSG00000198947), PKHD1L1 (ENSG00000205038), DYTN (ENSG00000232125), MICAL3 (ENSG00000243156), ACTN3 (ENSG00000248746), EPPK1 (ENSG00000261150), GAS2L2 (ENSG00000270765)

Protein

Protein identifiers

Alpha-actinin-4 — O43707 (reviewed: O43707)

Alternative names: Non-muscle alpha-actinin 4

All UniProt accessions (6): O43707, A0A0S2Z3G9, A0A8V8TL71, F5GXS2, H7C144, K7EP19

UniProt curated annotations — full annotation on UniProt →

Function. F-actin cross-linking protein which is thought to anchor actin to a variety of intracellular structures. This is a bundling protein. Probably involved in vesicular trafficking via its association with the CART complex. The CART complex is necessary for efficient transferrin receptor recycling but not for EGFR degradation. Involved in tight junction assembly in epithelial cells probably through interaction with MICALL2. Links MICALL2 to the actin cytoskeleton and recruits it to the tight junctions. May also function as a transcriptional coactivator, stimulating transcription mediated by the nuclear hormone receptors PPARG and RARA. Association with IGSF8 regulates the immune synapse formation and is required for efficient T-cell activation.

Subunit / interactions. Homodimer; antiparallel. Binds TRIM3 at the N-terminus. Interacts with MICALL2 (preferentially in opened conformation); stimulated by RAB13 activation. Identified in a complex with CASK, IQGAP1, MAGI2, NPHS1, SPTAN1 and SPTBN1. Identified in a IGF2BP1-dependent mRNP granule complex containing untranslated mRNAs. Component of the CART complex, at least composed of ACTN4, HGS/HRS, MYO5B and TRIM3. Interacts with MAGI1. Interacts with PDLIM2. Interacts with PPARG and RARA. Binds to VCL; this interaction triggers VCL conformational changes. Interacts with SEPTIN14. Interacts with IGSF8.

Subcellular location. Nucleus. Cytoplasm. Cell junction. Cytoskeleton. Stress fiber. Perinuclear region.

Tissue specificity. Widely expressed.

Disease relevance. Focal segmental glomerulosclerosis 1 (FSGS1) [MIM:603278] A renal pathology defined by the presence of segmental sclerosis in glomeruli and resulting in proteinuria, reduced glomerular filtration rate and progressive decline in renal function. Renal insufficiency often progresses to end-stage renal disease, a highly morbid state requiring either dialysis therapy or kidney transplantation. The disease is caused by variants affecting the gene represented in this entry.

Domain organisation. Contains one Leu-Xaa-Xaa-Leu-Leu (LXXLL) motif that mediates interaction with nuclear receptors.

Miscellaneous. Does not colocalize with actin cytoskeleton structures.

Similarity. Belongs to the alpha-actinin family.

Isoforms (3)

UniProt ID	Names	Canonical?
O43707-1	1	yes
O43707-2	ACTN4ISO
O43707-3	3

RefSeq proteins (3): NP_001308962, NP_001398072, NP_004915* (*=MANE)

Domains & families (InterPro)

ID	Name	Type
IPR001589	Actinin_actin-bd_CS	Conserved_site
IPR001715	CH_dom	Domain
IPR002017	Spectrin_repeat	Repeat
IPR002048	EF_hand_dom	Domain
IPR011992	EF-hand-dom_pair	Homologous_superfamily
IPR014837	EF-hand_Ca_insen	Domain
IPR018159	Spectrin/alpha-actinin	Repeat
IPR018247	EF_Hand_1_Ca_BS	Binding_site
IPR036872	CH_dom_sf	Homologous_superfamily

Pfam: PF00307, PF00435, PF08726

UniProt features (85 total): helix 18, sequence variant 17, sequence conflict 13, modified residue 10, region of interest 6, domain 4, repeat 4, binding site 3, strand 3, splice variant 2, turn 2, chain 1, short sequence motif 1, mutagenesis site 1

Structure

Experimental structures (PDB)

5 structures.

PDB	Method	Resolution (Å)
6OA6	X-RAY DIFFRACTION	1.37
6O31	X-RAY DIFFRACTION	1.51
1YDI	X-RAY DIFFRACTION	1.8
2R0O	X-RAY DIFFRACTION	2.2
1WLX	SOLUTION NMR

Predicted structure (AlphaFold)

Model	pLDDT	Fraction very-high
AF-O43707-F1	84.66	0.48

Functional residue map

Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.

Ligand- & substrate-binding residues (3): 778; 780; 789

Post-translational modifications (10): 31, 114, 214, 249, 592, 625, 696, 779, 859, 909

Mutagenesis-validated functional residues (1):

Position	Phenotype
87–88	reduced interaction with rara. loss of the transcriptional coac tivator activity toward rara.

Function

Pathways and Gene Ontology

Reactome pathways

6 pathways

ID	Pathway
R-HSA-114608	Platelet degranulation
R-HSA-373753	Nephrin family interactions
R-HSA-109582	Hemostasis
R-HSA-1500931	Cell-Cell communication
R-HSA-76002	Platelet activation, signaling and aggregation
R-HSA-76005	Response to elevated platelet cytosolic Ca2+

MSigDB gene sets: 437 (showing top): TSENG_IRS1_TARGETS_UP, GOBP_VESICLE_LOCALIZATION, GOBP_RESPONSE_TO_PEPTIDE, GOCC_SECRETORY_GRANULE, GOBP_SODIUM_ION_TRANSMEMBRANE_TRANSPORT, REACTOME_PLATELET_ACTIVATION_SIGNALING_AND_AGGREGATION, ENK_UV_RESPONSE_KERATINOCYTE_UP, GOBP_POSITIVE_REGULATION_OF_TRANSPORTER_ACTIVITY, TATTATA_MIR374, THEILGAARD_NEUTROPHIL_AT_SKIN_WOUND_DN, KYNG_DNA_DAMAGE_DN, KEGG_TIGHT_JUNCTION, GHO_ATF5_TARGETS_DN, GOBP_POSITIVE_REGULATION_OF_SODIUM_ION_TRANSPORT, CTATGCA_MIR153

GO Biological Process (13): protein transport (GO:0015031), actin cytoskeleton organization (GO:0030036), vesicle transport along actin filament (GO:0030050), positive regulation of cell migration (GO:0030335), positive regulation of sodium:proton antiporter activity (GO:0032417), tumor necrosis factor-mediated signaling pathway (GO:0033209), peroxisome proliferator activated receptor signaling pathway (GO:0035357), regulation of apoptotic process (GO:0042981), positive regulation of transcription by RNA polymerase II (GO:0045944), retinoic acid receptor signaling pathway (GO:0048384), muscle cell development (GO:0055001), negative regulation of substrate adhesion-dependent cell spreading (GO:1900025), positive regulation of non-canonical NF-kappaB signal transduction (GO:1901224)

GO Molecular Function (16): RNA polymerase II transcription regulatory region sequence-specific DNA binding (GO:0000977), nucleoside binding (GO:0001882), transcription coactivator activity (GO:0003713), RNA binding (GO:0003723), actin binding (GO:0003779), integrin binding (GO:0005178), calcium ion binding (GO:0005509), nuclear receptor binding (GO:0016922), chromatin DNA binding (GO:0031490), protein homodimerization activity (GO:0042803), nuclear retinoic acid receptor binding (GO:0042974), transmembrane transporter binding (GO:0044325), actin filament binding (GO:0051015), protein binding (GO:0005515), identical protein binding (GO:0042802), metal ion binding (GO:0046872)

GO Cellular Component (21): stress fiber (GO:0001725), extracellular region (GO:0005576), obsolete extracellular space (GO:0005615), nucleus (GO:0005634), cytoplasm (GO:0005737), plasma membrane (GO:0005886), focal adhesion (GO:0005925), actin cytoskeleton (GO:0015629), Z disc (GO:0030018), cell junction (GO:0030054), cortical actin cytoskeleton (GO:0030864), platelet alpha granule lumen (GO:0031093), pseudopodium (GO:0031143), protein-containing complex (GO:0032991), cell projection (GO:0042995), perinuclear region of cytoplasm (GO:0048471), extracellular exosome (GO:0070062), postsynaptic actin cytoskeleton (GO:0098871), ribonucleoprotein complex (GO:1990904), cytoskeleton (GO:0005856), anchoring junction (GO:0070161)

Reactome top-level categories

Rollup of top-4 pathways:

Category	Pathways
Response to elevated platelet cytosolic Ca2+	1
Cell-Cell communication	1
Hemostasis	1
Platelet activation, signaling and aggregation	1

GO top-level categories

Rollup of top GO terms by namespace:

Category	Terms
cellular anatomical structure	6
nuclear receptor-mediated signaling pathway	2
positive regulation of DNA-templated transcription	2
protein-containing complex binding	2
protein binding	2
actin cytoskeleton	2
transport	1
intracellular protein localization	1
establishment of protein localization	1
cytoskeleton organization	1
actin filament-based process	1
actin filament-based movement	1
actin filament-based transport	1
vesicle cytoskeletal trafficking	1
cell migration	1
regulation of cell migration	1
positive regulation of cell motility	1
sodium:proton antiporter activity	1
positive regulation of sodium ion transmembrane transporter activity	1
cytokine-mediated signaling pathway	1
cellular response to tumor necrosis factor	1
apoptotic process	1
regulation of programmed cell death	1
regulation of transcription by RNA polymerase II	1
transcription by RNA polymerase II	1
hormone-mediated signaling pathway	1
muscle cell differentiation	1
cell development	1
negative regulation of cell-substrate adhesion	1
substrate adhesion-dependent cell spreading	1
regulation of substrate adhesion-dependent cell spreading	1
non-canonical NF-kappaB signal transduction	1
regulation of non-canonical NF-kappaB signal transduction	1
positive regulation of intracellular signal transduction	1
transcription cis-regulatory region binding	1
carbohydrate derivative binding	1
heterocyclic compound binding	1
transcription coregulator activity	1
nucleic acid binding	1
cytoskeletal protein binding	1

Protein interactions and networks

STRING

2468 interactions, top by confidence (×1000):

Protein A	Protein B	Partner UniProt	Score
ACTN4	NPHS1	O60500	988
ACTN4	SYNPO	Q8N3V7	979
ACTN4	NPHS2	Q9NP85	971
ACTN4	VCL	P18206	965
ACTN4	CD2AP	Q9Y5K6	939
ACTN4	INF2	Q27J81	929
ACTN4	MAGI1	Q96QZ7	922
ACTN4	TRPC6	Q9Y210	904
ACTN4	TRIM3	O75382	879
ACTN4	TJP1	Q07157	873
ACTN4	TLN1	Q9Y490	859
ACTN4	MYH9	P35579	840
ACTN4	PLCE1	Q9P212	824
ACTN4	PDLIM1	O00151	821
ACTN4	PDLIM2	Q96JY6	794

IntAct

283 interactions, top by confidence:

A	B	Type	Score
ACTN4	MYOZ2	psi-mi:“MI:0915”(physical association)	0.930
MYOZ2	ACTN4	psi-mi:“MI:0915”(physical association)	0.930
PDLIM1	ACTN4	psi-mi:“MI:0914”(association)	0.800
ACTN4	PDLIM1	psi-mi:“MI:0915”(physical association)	0.800
CFTR	ESYT2	psi-mi:“MI:0914”(association)	0.710
CTNNB1	ACTN4	psi-mi:“MI:0914”(association)	0.680
ACTN4	CTNNB1	psi-mi:“MI:0915”(physical association)	0.680
ACTN4	CTNNB1	psi-mi:“MI:0403”(colocalization)	0.680

BioGRID (552): ACTN4 (Affinity Capture-MS), ACTN3 (Two-hybrid), BMP7 (Two-hybrid), MYOZ2 (Two-hybrid), ACTN4 (Affinity Capture-MS), ACTN4 (Affinity Capture-MS), ACTN4 (Affinity Capture-MS), ACTN4 (Affinity Capture-MS), ACTN4 (Two-hybrid), ACTN4 (Affinity Capture-MS), ACTN4 (Affinity Capture-Western), RARA (Reconstituted Complex), ACTN4 (Affinity Capture-MS), MYOZ2 (Two-hybrid), MYOZ1 (Two-hybrid)

ESM2 similar proteins: A5D7D1, L7UZ85, O43707, O88990, P05094, P11277, P12814, P15508, P18091, P20111, P26232, P30997, P35609, P46940, P57780, Q00078, Q00963, Q01082, Q08043, Q0E908, Q0III9, Q13576, Q2PFV7, Q3B7N2, Q3UQ44, Q3ZC55, Q4QR29, Q4WVG0, Q5M7J9, Q5R416, Q5RCS6, Q61301, Q62018, Q62261, Q6DEU9, Q6INS3, Q6NXC0, Q6PD62, Q7G188, Q7PKQ5

Diamond homologs: A5D7D1, D3ZEN0, D3ZHA0, D3ZHV2, D3ZQL6, E1BBG2, F1MF74, F1RA39, F6QZ15, G3MWR8, G3V7L1, L7UZ85, M9MRD1, O13728, O15020, O43707, O75369, O76329, O88990, O94851, O97592, P05094, P05095, P07751, P11277, P11530, P11531, P11532, P11533, P12814, P13395, P13466, P15508, P16086, P16546, P18091, P20111, P21333, P30427, P35609

SIGNOR signaling

3 interactions.

A	Effect	B	Mechanism
PTK2	up-regulates	ACTN4	phosphorylation
PTK2	down-regulates	ACTN4	phosphorylation

Enriched among interaction partners

Reactome pathways and GO biological processes over-represented among this gene’s 141 IntAct physical interaction partners (hypergeometric vs the genome-wide background, BH-FDR, gene-set size 15–500, ranked by fold). A functional readout of the neighbourhood — distinct from this gene’s own memberships above, and biased toward well-studied / hub proteins, so read it as themes rather than proof.

Reactome pathways:

Pathway	Partners	Fold	FDR
FCGR3A-mediated phagocytosis	5	11.0×	1e-02
RHOQ GTPase cycle	5	10.7×	1e-02
Regulation of PLK1 Activity at G2/M Transition	6	9.0×	7e-03
RHO GTPase Effectors	8	6.4×	7e-03
Signaling by Rho GTPases, Miro GTPases and RHOBTB3	12	4.7×	5e-03
Signaling by Rho GTPases	11	4.4×	7e-03

GO biological processes:

GO term	Partners	Fold	FDR
epidermal growth factor receptor signaling pathway	5	10.9×	1e-02
actin cytoskeleton organization	13	9.0×	3e-06
protein phosphorylation	9	5.4×	5e-03
negative regulation of apoptotic process	13	4.0×	5e-03

Disease & clinical

Clinical variants and AI predictions

ClinVar

596 variants total. Per-class counts are floors (≥ shown; pagination cap):

Classification	Count (floor)
Pathogenic	6
Likely pathogenic	11
Uncertain significance	255
Likely benign	169
Benign	59

Top pathogenic / likely-pathogenic (17)

Variant ID	HGVS	Classification
235864	NM_004924.6(ACTN4):c.584G>A (p.Gly195Asp)	Pathogenic
2500724	NM_004924.6(ACTN4):c.584G>T (p.Gly195Val)	Pathogenic
2736886	NM_004924.6(ACTN4):c.445ATC[1] (p.Ile150del)	Pathogenic
5420	NM_004924.6(ACTN4):c.763A>G (p.Lys255Glu)	Pathogenic
5421	NM_004924.6(ACTN4):c.776C>T (p.Thr259Ile)	Pathogenic
5422	NM_004924.6(ACTN4):c.784T>C (p.Ser262Pro)	Pathogenic
1028308	NM_004924.6(ACTN4):c.175T>C (p.Trp59Arg)	Likely pathogenic
2572429	NM_004924.6(ACTN4):c.493G>A (p.Ala165Thr)	Likely pathogenic
3035302	NM_004924.6(ACTN4):c.608A>C (p.His203Pro)	Likely pathogenic
3061635	NM_004924.6(ACTN4):c.506T>G (p.Leu169Arg)	Likely pathogenic
3068392	NM_004924.6(ACTN4):c.517T>C (p.Cys173Arg)	Likely pathogenic
3236342	NM_004924.6(ACTN4):c.718A>G (p.Met240Val)	Likely pathogenic
3900730	NM_004924.6(ACTN4):c.757G>A (p.Asp253Asn)	Likely pathogenic
4084962	NM_004924.6(ACTN4):c.214G>C (p.Glu72Gln)	Likely pathogenic
4796795	NM_004924.6(ACTN4):c.773T>C (p.Met258Thr)	Likely pathogenic
599063	NM_004924.6(ACTN4):c.510_512del (p.Leu171del)	Likely pathogenic
599130	NM_004924.6(ACTN4):c.458T>C (p.Phe153Ser)	Likely pathogenic

SpliceAI

4101 predictions. Top by Δscore:

Variant	Effect	Δscore
19:38647905:AAGGT:A	donor_loss	1.0000
19:38647906:AGGTG:A	donor_loss	1.0000
19:38647907:GGTG:G	donor_loss	1.0000
19:38647908:G:GG	donor_gain	1.0000
19:38647908:GT:G	donor_loss	1.0000
19:38700589:T:TA	acceptor_gain	1.0000
19:38700594:CCCCA:C	acceptor_loss	1.0000
19:38700596:CCA:C	acceptor_loss	1.0000
19:38700598:A:AG	acceptor_gain	1.0000
19:38700598:A:C	acceptor_loss	1.0000
19:38700599:G:GA	acceptor_gain	1.0000
19:38700599:GA:G	acceptor_gain	1.0000
19:38700599:GAC:G	acceptor_gain	1.0000
19:38700599:GACC:G	acceptor_gain	1.0000
19:38700599:GACCT:G	acceptor_gain	1.0000
19:38700711:TCAG:T	donor_loss	1.0000
19:38700715:G:T	donor_loss	1.0000
19:38700988:T:TA	acceptor_gain	1.0000
19:38700990:T:TA	acceptor_gain	1.0000
19:38700993:A:AG	acceptor_gain	1.0000
19:38700994:C:G	acceptor_gain	1.0000
19:38701000:A:AG	acceptor_gain	1.0000
19:38701000:AG:A	acceptor_gain	1.0000
19:38701000:AGG:A	acceptor_gain	1.0000
19:38701000:AGGG:A	acceptor_gain	1.0000
19:38701001:G:GA	acceptor_gain	1.0000
19:38701001:GG:G	acceptor_gain	1.0000
19:38701001:GGG:G	acceptor_gain	1.0000
19:38701001:GGGG:G	acceptor_gain	1.0000
19:38701001:GGGGA:G	acceptor_gain	1.0000

AlphaMissense

6111 scored. Top likely-pathogenic:

Variant	Protein change	am_pathogenicity
19:38647887:T:A	W48R	1.000
19:38647887:T:C	W48R	1.000
19:38647889:G:C	W48C	1.000
19:38647889:G:T	W48C	1.000
19:38647900:A:C	Q52P	1.000
19:38647901:G:C	Q52H	1.000
19:38647901:G:T	Q52H	1.000
19:38647903:G:C	R53P	1.000
19:38700603:T:A	F56I	1.000
19:38700603:T:C	F56L	1.000
19:38700604:T:C	F56S	1.000
19:38700604:T:G	F56C	1.000
19:38700605:C:A	F56L	1.000
19:38700605:C:G	F56L	1.000
19:38700612:T:A	W59R	1.000
19:38700612:T:C	W59R	1.000
19:38700613:G:C	W59S	1.000
19:38700614:G:C	W59C	1.000
19:38700614:G:T	W59C	1.000
19:38700615:T:C	C60R	1.000
19:38700616:G:A	C60Y	1.000
19:38700617:C:G	C60W	1.000
19:38700621:T:C	S62P	1.000
19:38700624:C:G	H63D	1.000
19:38700628:T:A	L64Q	1.000
19:38700628:T:C	L64P	1.000
19:38700678:G:A	G81R	1.000
19:38700678:G:C	G81R	1.000
19:38700678:G:T	G81W	1.000
19:38700679:G:A	G81E	1.000

dbSNP variants (sampled 300 via entrez): RS1000043704 (19:38699663 G>A,T), RS1000116175 (19:38672359 G>T), RS1000140544 (19:38689761 C>T), RS1000150687 (19:38699181 T>C), RS1000201936 (19:38654067 A>C), RS1000215632 (19:38658727 G>A,C), RS1000254141 (19:38654328 G>A), RS1000348394 (19:38682020 G>A), RS1000372966 (19:38719783 A>C), RS1000395227 (19:38647598 G>A,T), RS1000524619 (19:38693504 C>G,T), RS1000526476 (19:38678162 G>A), RS1000538274 (19:38715314 T>A), RS1000561245 (19:38655301 C>T), RS1000597214 (19:38698431 G>T)

Disease associations

OMIM: gene MIM:604638 | disease phenotypes: MIM:603278, MIM:614607

GenCC curated gene-disease

Disease	Classification	Inheritance
focal segmental glomerulosclerosis 1	Strong	Autosomal dominant
familial idiopathic steroid-resistant nephrotic syndrome	Supportive	Autosomal dominant

Mondo (7): focal segmental glomerulosclerosis 1 (MONDO:0011303), focal segmental glomerulosclerosis (MONDO:0100313), kidney disorder (MONDO:0005240), intellectual disability, autosomal dominant 14 (MONDO:0013819), chronic kidney disease (MONDO:0005300), nephrotic syndrome (MONDO:0005377), familial idiopathic steroid-resistant nephrotic syndrome (MONDO:0019006)

Orphanet (3): Hereditary steroid-resistant nephrotic syndrome (Orphanet:656), Coffin-Siris syndrome (Orphanet:1465), OBSOLETE: Familial idiopathic steroid-resistant nephrotic syndrome with focal segmental hyalinosis (Orphanet:93213)

HPO phenotypes

27 total (27 of 27 shown, HPO-id order):

HPO	Term
HP:0000006	Autosomal dominant inheritance
HP:0000093	Proteinuria
HP:0000097	Focal segmental glomerulosclerosis
HP:0000707	Abnormality of the nervous system
HP:0000737	Irritability
HP:0000822	Hypertension
HP:0000969	Edema
HP:0001541	Ascites
HP:0001903	Anemia
HP:0001945	Fever
HP:0001967	Diffuse mesangial sclerosis
HP:0002027	Abdominal pain
HP:0002202	Pleural effusion
HP:0002315	Headache
HP:0002586	Peritonitis
HP:0003073	Hypoalbuminemia
HP:0003077	Hyperlipidemia
HP:0003677	Slowly progressive
HP:0003774	Stage 5 chronic kidney disease
HP:0003829	Typified by incomplete penetrance
HP:0004719	Hyperechogenic kidneys
HP:0005565	Reduced renal corticomedullary differentiation
HP:0011947	Respiratory tract infection
HP:0012579	Minimal change glomerulonephritis
HP:0012622	Chronic kidney disease
HP:0031504	Foamy urine
HP:0100539	Periorbital edema

GWAS associations

9 associations (top):

Study	Trait	p-value
GCST001969_30	Heart rate	2.000000e-06
GCST006999_4	Logical memory (immediate recall) in mild cognitive impairment	4.000000e-07
GCST008151_16	Waist circumference	7.000000e-06
GCST008160_61	Waist circumference	7.000000e-06
GCST009422_1	Retinal venular tortuosity	2.000000e-13
GCST010703_256	Brain morphology (MOSTest)	8.000000e-14
GCST012047_17	Fasting glucose	7.000000e-07
GCST90002387_53	Immature fraction of reticulocytes	1.000000e-09
GCST90002395_411	Mean platelet volume	1.000000e-14

EFO canonical traits (3, from GWAS)

EFO ID	Trait name
EFO:0004874	memory performance
EFO:0010554	retinal vasculature measurement
EFO:0004346	neuroimaging measurement

MeSH disease descriptors (5)

Descriptor	Name	Tree numbers
D005923	Glomerulosclerosis, Focal Segmental	C12.050.351.968.419.570.363.640; C12.200.777.419.570.363.660; C12.950.419.570.363.640
D007674	Kidney Diseases	C12.050.351.968.419; C12.200.777.419; C12.950.419
D007676	Kidney Failure, Chronic	C12.050.351.968.419.780.750.500; C12.200.777.419.780.750.500; C12.950.419.780.750.500; C23.550.291.500.906.500
D009404	Nephrotic Syndrome	C12.050.351.968.419.630.643; C12.200.777.419.630.643; C12.950.419.630.643
C538457	Segmental glomerulosclerosis (supp.)

Drugs & pharmacology

Drug and pharmacology data

Is drug target: yes

ChEMBL targets (1): CHEMBL5724737 (SINGLE PROTEIN)

Molecules with ChEMBL bioactivity

1 molecules (phase ≥1), by development phase (incl. off-target/promiscuous compounds). Patent mentions across the top 20 by phase: 1,538 (via chembl_molecule»patent_compound — counts attach to the compound, not the gene–compound relationship, so off-target/promiscuous molecules can dominate).

Molecule	Name	Phase	Patents
CHEMBL1232461	MOLIBRESIB	2	1,538

PharmGKB: 1 entry (VIP=true, CPIC=false)

ChEMBL bioactivities

5 potent at pChembl≥5 of 5 total, top 5 by pChembl (potency: 10 = 0.1 nM, 6 = 1 µM).

pChembl	Type	Value	Unit	Molecule
6.92	Kd	120.3	nM	CHEMBL5653589
6.92	ED50	120.3	nM	CHEMBL5653589
6.28	IC50	530	nM	MOLIBRESIB
5.40	Kd	4006	nM	CHEMBL3752910
5.40	ED50	4006	nM	CHEMBL3752910

PubChem BioAssay actives

3 with measured affinity, of 10 total; 3 most potent distinct compounds. Largely complementary to BindingDB; screening values are coarse (µM, 4 dp), so sub-nM hits tie at the floor.

Compound	Assay	Type	Value	Unit
4-methyl-3-[(2-methyl-6-pyridin-3-ylpyrazolo[3,4-d]pyrimidin-4-yl)amino]-N-[3-(trifluoromethyl)phenyl]benzamide	2147797: Binding affinity to human ACTN4 incubated for 45 mins by Kinobead based pull down assay	kd	0.1203	uM
2-[(4S)-6-(4-chlorophenyl)-8-methoxy-1-methyl-4H-[1,2,4]triazolo[4,3-a][1,4]benzodiazepin-4-yl]-N-ethylacetamide	2178896: Inhibition of ACTN4 (unknown origin) incubated for 1 hr by colloidal coomassie staining based LC-MS/MS analysis	ic50	0.5300	uM
4-methyl-3-[(1-methyl-6-pyridin-3-ylpyrazolo[3,4-d]pyrimidin-4-yl)amino]-N-[3-(trifluoromethyl)phenyl]benzamide	2147797: Binding affinity to human ACTN4 incubated for 45 mins by Kinobead based pull down assay	kd	4.0058	uM

CTD chemical–gene interactions

59 total (human), top 30 by PubMed support.

Chemical	Actions (top 5)	PubMed papers
bisphenol A	affects cotreatment, increases methylation, decreases methylation, increases expression, affects expression	4
Tobacco Smoke Pollution	affects expression, decreases expression, increases expression	3
Aflatoxin B1	decreases expression, increases methylation, affects cotreatment	3
Air Pollutants	decreases expression, increases abundance, increases expression	2
Particulate Matter	decreases expression, increases abundance, affects cotreatment, increases expression	2
aristolochic acid I	increases expression	1
FR900359	increases phosphorylation	1
triphenyl phosphate	affects expression	1
sodium arsenate	decreases expression	1
pyrogallol 1,3-dimethyl ether	decreases expression, affects localization, increases expression, affects cotreatment	1
quercitrin	affects expression	1
beta-lapachone	increases expression	1
arsenite	affects binding, increases reaction	1
sodium arsenite	decreases expression	1
cobaltous chloride	decreases expression	1
4-hydroxy-2-nonenal	affects binding	1
aflatoxin B2	increases methylation	1
cupric oxide	increases expression	1
beta-methylcholine	affects expression	1
perfluorooctane sulfonic acid	decreases expression	1
2,3,5-(triglutathion-S-yl)hydroquinone	increases ADP-ribosylation	1
CGP 52608	affects binding, increases reaction	1
chloropicrin	increases expression	1
K 7174	decreases expression	1
4-(5-benzo(1,3)dioxol-5-yl-4-pyridin-2-yl-1H-imidazol-2-yl)benzamide	affects cotreatment, decreases expression	1
bisphenol B	increases expression	1
bromovanin	increases expression	1
bisphenol S	increases expression	1
LDN 193189	affects cotreatment, decreases expression	1
(+)-JQ1 compound	increases expression	1

ChEMBL screening assays

7 unique, capped per target: 7 binding

Representative assays (with source publication via chembl_document):

Assay ID	Type	Description	Source paper
CHEMBL5650839	Binding	Binding affinity to human ACTN4 incubated for 45 mins by Kinobead based pull down assay	NVP-BHG712: Effects of Regioisomers on the Affinity and Selectivity toward the EPHrin Family. — ChemMedChem

Cellosaurus cell lines

2 cell lines: 2 cancer cell line

First 10 cell lines (id-ordered, not curated):

Cellosaurus	Name	Category	Sex
CVCL_SB30	HAP1 ACTN4 (-) 1	Cancer cell line	Male
CVCL_XL02	HAP1 ACTN4 (-) 2	Cancer cell line	Male

Clinical trials (associated diseases)

300 trials via MONDO — disease-level, not drug-specific.

Trial	Phase	Status	Title
NCT01129557	PHASE4	TERMINATED	Aldosterone Breakthrough During Diovan, Tekturna, and Combination Therapy in Patients With Proteinuric Kidney Disease
NCT02399462	PHASE4	WITHDRAWN	Acthar for Treatment of Post-transplant FSGS
NCT02585804	PHASE4	COMPLETED	Treating to Reduce Albuminuria and Normalize Hemodynamic Function in Focal ScLerosis With dApagliflozin Trial Effects
NCT02633046	PHASE4	COMPLETED	Acthar for Treatment-Resistant or Treatment-Intolerant Proteinuria
NCT07219121	PHASE4	RECRUITING	Sparsentan in Posttransplant Immunoglobulin A Nephropathy or Focal Segmental Glomerulosclerosis
NCT00067990	PHASE4	COMPLETED	Angiotensin II Blockade for Chronic Allograft Nephropathy
NCT00117078	PHASE4	COMPLETED	Aranesp® Monthly Preference Study - 2
NCT00117130	PHASE4	COMPLETED	Study to Evaluate Effectiveness of Aranesp®
NCT00132431	PHASE4	COMPLETED	START: Sensipar Treatment Algorithm to Reach K/DOQI Targets in Chronic Kidney Disease Subjects With Secondary Hyperparathyroidism
NCT00140985	PHASE4	COMPLETED	Antiproteinuric Efficacy of Losartan Potassium in Patients With Non-Diabetic Proteinuric Renal Diseases (0954-213)
NCT00246129	PHASE4	COMPLETED	CamTac Trial:Campath-Tacrolimus vs IL2R MoAb/Tacrolimus/MMF in Renal Transplantation
NCT00275535	PHASE4	COMPLETED	The Comparison of Tacrolimus and Sirolimus Immunosuppression Based Drug Regimens in Kidney Transplant Recipients
NCT00282217	PHASE4	COMPLETED	Study Evaluating Sirolimus in the Treatment of Kidney Transplant
NCT00289614	PHASE4	COMPLETED	Patients With Renal Impairment and Diabetes Undergoing Computed Tomography (CT)
NCT00290069	PHASE4	UNKNOWN	Renal Function Optimization With Mycophenolate Mofetil (MMF) Immunosuppressor Regimes (ALHAMBRA)
NCT00338468	PHASE4	TERMINATED	A Study to Assess Disability in Anemic Elderly Patients With Kidney Disease Receiving PROCRIT (Epoetin Alfa)
NCT00368901	PHASE4	COMPLETED	STAAR-2 Clinical Study
NCT00369733	PHASE4	COMPLETED	STAAR-3 Clinical Study
NCT00369772	PHASE4	COMPLETED	STAAR-1 Clinical Study
NCT00379899	PHASE4	COMPLETED	ADVANCE: Study to Evaluate Cinacalcet Plus Low Dose Vitamin D on Vascular Calcification in Subjects With Chronic Kidney Disease Receiving Hemodialysis
NCT00443508	PHASE4	UNKNOWN	Reduction or Discontinuation of CNI’s With Conversion to Everolimus-Based Immunosuppresion
NCT00452478	PHASE4	TERMINATED	Conversion From Standard Phosphate Binder Therapy to Fosrenol® (Lanthanum Carbonate) in Chronic Kidney Disease Stage 5
NCT00492518	PHASE4	COMPLETED	Acetylcysteine, Theophylline, and a Combination of Both in the Prophylaxis of Contrast-Induced Nephropathy
NCT00505102	PHASE4	UNKNOWN	Safe Renal Function In Long Term Heart Transplanted Patients
NCT00526331	PHASE4	COMPLETED	Evaluation of Arterial Pressure Based Cardiac Output for Goal-Directed Perioperative Therapy
NCT00688480	PHASE4	COMPLETED	Do Xanthine Oxidase Inhibitors Reduce Both Left Ventricular Hypertrophy and Endothelial Dysfunction in Cardiovascular Patients With Renal Dysfunction?
NCT00863707	PHASE4	COMPLETED	A Study of the Safety and Tolerance of Regadenoson in Subjects With Renal Impairment
NCT01101698	PHASE4	UNKNOWN	Vitamin K2 and Vessel Calcification in Chronic Kidney Disease Patients
NCT01150201	PHASE4	COMPLETED	Aliskiren Combined With Losartan in Proteinuric, Non-diabetic Chronic Kidney Disease
NCT01155141	PHASE4	COMPLETED	Idiopathic Focal Segmental Glomerulosclerosis (FSGS) and Treatment With ACTH
NCT01228279	PHASE4	COMPLETED	Sympathetic Activity in Patients With End-stage Renal Disease on Peritoneal Dialysis
NCT01334333	PHASE4	COMPLETED	Comparison of Medication Adherence Between Once and Twice Daily Tacrolimus in Stable Renal Transplant Recipients
NCT01437943	PHASE4	TERMINATED	Effect of Short Term Aliskiren Treatment in Kidney Transplant Patients
NCT01545479	PHASE4	COMPLETED	Increased Renal Oxygenation and Angiotensin Converting Enzyme Inhibition
NCT01614431	PHASE4	COMPLETED	N Acetyl Cysteine for Cystinosis Patients
NCT01631149	PHASE4	COMPLETED	Effect of Deep BLock on Intraoperative Surgical Conditions
NCT01722513	PHASE4	UNKNOWN	Efficacy and Safety of Alprostadil Prevent Contrast Induced Nephropathy
NCT01985360	PHASE4	COMPLETED	ISCHEMIA-Chronic Kidney Disease Trial
NCT02311010	PHASE4	UNKNOWN	Practical Use of Advagraf de Novo After Kidney Transplantation According to Recipient Genetic Polymorphism
NCT02413073	PHASE4	COMPLETED	Whole Body Vibration in Kidney Disease