WAGR syndrome


00:00 / 00:00



WAGR syndrome


Renal and ureteral disorders

Renal agenesis

Horseshoe kidney

Potter sequence











Renal tubular acidosis

Minimal change disease

Diabetic nephropathy

Focal segmental glomerulosclerosis (NORD)


Membranous nephropathy

Lupus nephritis

Membranoproliferative glomerulonephritis

Poststreptococcal glomerulonephritis

Goodpasture syndrome

Rapidly progressive glomerulonephritis

IgA nephropathy (NORD)

Lupus nephritis

Alport syndrome

Kidney stones


Acute pyelonephritis

Chronic pyelonephritis

Prerenal azotemia

Renal azotemia

Acute tubular necrosis

Postrenal azotemia

Renal papillary necrosis

Renal cortical necrosis

Chronic kidney disease

Polycystic kidney disease

Multicystic dysplastic kidney

Medullary cystic kidney disease

Medullary sponge kidney

Renal artery stenosis

Renal cell carcinoma


Nephroblastoma (Wilms tumor)

WAGR syndrome

Beckwith-Wiedemann syndrome

Bladder and urethral disorders

Posterior urethral valves

Hypospadias and epispadias

Vesicoureteral reflux

Bladder exstrophy

Urinary incontinence

Neurogenic bladder

Lower urinary tract infection

Transitional cell carcinoma

Non-urothelial bladder cancers

Renal system pathology review

Congenital renal disorders: Pathology review

Renal tubular defects: Pathology review

Renal tubular acidosis: Pathology review

Acid-base disturbances: Pathology review

Electrolyte disturbances: Pathology review

Renal failure: Pathology review

Nephrotic syndromes: Pathology review

Nephritic syndromes: Pathology review

Urinary incontinence: Pathology review

Urinary tract infections: Pathology review

Kidney stones: Pathology review

Renal and urinary tract masses: Pathology review


WAGR syndrome


0 / 5 complete

High Yield Notes

9 pages


WAGR syndrome

of complete


Content Reviewers

Rishi Desai, MD, MPH


Tanner Marshall, MS

WAGR syndrome stands for Wilms’ tumor, aniridia, genitourinary anomalies, and mental retardation, which is now called intellectual disability, and this is a genetic disorder that’s caused when a part of chromosome 11 is missing, or deleted.

Not everyone with WAGR has all of the symptoms, for example only about a half of the individuals have Wilms’ tumor.

On the flip side, some have additional symptoms, too, like progressive kidney failure, growth retardation, small head size, and obesity.

The most specific feature of WAGR syndrome is aniridia, which is the complete or partial absence of the iris, the colored part of the eye. And this is an easily noticeable feature, and it’s present at birth, so it’s usually the first thing to raise suspicion of WAGR syndrome.

Now, a normal iris controls how much light enters the eye, and it constricts the pupil when there’s a lot of light around to keep the vision sharp. With aniridia, too much light gets into the eye, which leads to blurry vision and photophobia, which is discomfort when the eyes are exposed to light.

Additional eye features in WAGR syndrome can include cataracts, which is a clouded lens, glaucoma, or increased pressure in the eye, and nystagmus—abnormal rhythmic eye movements of the eye.

Wilms’ tumor, also called nephroblastoma, is generally a malignant kidney tumor that affects children.

Wilms’ tumor’s composed of metanephric blastema, which is a cell type that’s seen in the developing kidney, stromal cells which are part of the connective tissue, and epithelial cells which self-organize into primitive glomeruli and tubules.

Children with Wilms’ tumor often develop a large flank mass, as well as hematuria, which is blood in the urine, and hypertension.

Now, that hypertension is a result of increased renin secretion; which either comes from the tumor itself or from healthy kidney tissue that secretes renin because it’s physically compressed by the tumor.


WAGR syndrome is a rare genetic disorder caused by a deletion or mutation of certain genes on chromosome 11. It is characterized by four main features: Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. People with WAGR syndrome can also present with cataracts, glaucoma, and nystagmus. The severity and range of symptoms can vary widely among affected individuals. Treatment usually involves a multidisciplinary approach, including surgical intervention for Wilms tumor, management of developmental and intellectual issues, and regular monitoring for potential health issues.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "WAGR Syndrome: A Clinical Review of 54 Cases" Pediatrics (2005)
  6. "Brain-Derived Neurotrophic Factor and Obesity in the WAGR Syndrome" New England Journal of Medicine (2008)
  7. "Association of Wilms's Tumor with Aniridia, Hemihypertrophy and Other Congenital Malformations" New England Journal of Medicine (1964)

Copyright © 2023 Elsevier, except certain content provided by third parties

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.