Mp63-05 Urinary Metabolic Disturbances and VDR Gene Polymorphisms as Prognostic Factors for Recurrence of Calcium Oxalate Renal Calculi: A Prospective Controlled Trial

You have accessJournal of UrologyStone Disease: Basic Research FokI (rs2228570) and TaqI (rs731236) in selected patients with calcium oxalate (CaOx) renal stones and their long-term impact on stone recurrence (SR). METHODS: After renal stone treatment and analysis, 84 patients with predominant CaOx stones (≥70% of stone structure) were enrolled (after informed consent) provided they had recurrent stones, no family history of stone disease and no anatomic abnormality precipitating stone disease (e.g. stricture). Full history, examination and investigations were done. Compared to 30 healthy control cases, Gene testing was done from peripheral blood samples. Also, UM were evaluated and compared to the reported standard cut-off values. All cases were followed up at 3, 6, 12 and 24 months where non contrast CT assesed SR. RESULTS: 47 (56%) patients were males and 37 (44%) were females with mean age; 51.4±16 years. UM testing showed hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia, hypomagnesuria and combined abnormalities evident in 4 (5%), 22 (26 %), 2 (2.4%), 18 (21%) and 2 (2.4%) and 15 (18%) patients, respectively. VDR Gene testing in the study vs the control group showed significant FokI mutations (p<0.0001) where 33 patients (39%) had TT homgenous mutation, 31 (37%) patients had TC heterogenous mutation and 20 (24%) had wild CC genotype. TaqI showed comparable results in both groups. Both FokI & TaqI were comparable in both genders. 78 patients were available for final analysis where 22/78 (28%) cases developed SR evident by CT at 6, 12 and 24 months in 6 (8%), 11 (14%) and 5 (6%) patients respectively. No significant impact of baseline UM defects on SR (p=0.19), even it occurred in 9 (11.5%) patients with normal baseline UM, (HR 0.67, 95% CI (0.23-2.02)). FokI was found to be a significant risk factor for SR at 2 years (p<0.0001) with the presence of T allele especially TC genotype. TaqI showed no impact on SR (p=0.23) Table 1. CONCLUSIONS: Recurrence of Calcium renal stones is multifactorial and VDR gene FokI plymorphism emerges as an important contributor. Although UM disturbances showed no impact on stone recurrence in our study, their identification and proper management is essential for prophylaxis against recurrence. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1032 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmed Elhussein A. E. Abolazm More articles by this author Ahmed Mohammed A. M. Elshal More articles by this author Nasr Ahmed N. A. Eltabey More articles by this author Mahmoud Anees Bazeed More articles by this author Ahmed Mamdouh A. M. Shoma More articles by this author Expand All Advertisement PDF downloadLoading ...