Alport syndrome is a genetic disorder that is characterized by glomerulonephritis, often in combination with sensorineural hearing loss and sometimes eye abnormalities. It is caused by a genetic defect of type IV collagen, which is usually inherited in an X-linked dominant pattern. Patients typically present with intermittent gross hematuria during infancy. In adolescence, patients classically start to develop more serious signs of chronic kidney disease (e.g., proteinuria), and may experience hearing loss or, in rare cases, vision problems. In milder forms, patients may remain asymptomatic and only require monitoring. In classic Alport syndrome, diagnostic evaluation shows persistent microhematuria on urinalysis and splitting of the glomerular basement membrane on kidney biopsy. The classic form usually leads to end-stage renal disease (ESRD) between the second and third decade of life, and the only definitive treatment is a kidney transplant.
- Rare disorder 
- The most common hereditary nephritis
Epidemiological data refers to the US, unless otherwise specified.
- Age of onset can vary markedly among individuals (from infancy to late adulthood) depending on the underlying genetic defect
- Often asymptomatic
- Initially intermittent gross hematuria (may present in infancy)
- As glomerular damage progresses, symptoms of nephritic syndrome and chronic kidney disease occur (usually leads to ESRD between 16–35 years of age) 
- Sensorineural hearing loss
- Ocular findings: retinopathy, anterior lenticonus (a congenital conical elevation at the anterior pole or posterior pole of the crystalline lens in the eye)
Patients with Alport syndrome can't pee, can't see, can't hear a bee.
- Laboratory tests
- Skin biopsy
- Light microscopy: mesangial cell proliferation and sclerosis
- Electron microscopy: splitting and alternating irregular thickening and thinning of the glomerular basement membrane (“basket-weave appearance”)
- Immunostaining: absence of the type IV collagen alpha-3, alpha-4, and/or alpha-5 chains in the basement membrane
- Molecular genetic testing: can confirm and distinguish subtypes
- Monitor renal function regularly
- In patients with proteinuria: ACE inhibitors/angiotensin II receptor blockers
- In patients with renal failure: See “Treatment” in “ ” (e.g., sodium restriction, diuretics).
- Kidney transplant
- hearing loss in patients with
- Consider ocular surgery in patients with lenticonus