Genetic polymorphisms as prognostic factors for recurrent kidney stones: A systematic review and meta-analysis
PLoS One. 2021 May 6;16(5):e0251235. doi: 10.1371/journal.pone.0251235
Widi Atmoko 1, Putu Angga Risky Raharja 1, Ponco Birowo 1, Agus Rizal Ardy Hariandy Hamid 1, Akmal Taher 1, Nur Rasyid 1
For decades it was incorrectly assumed that higher Vitamin D ==> increased risk of kidney stones
- Vitamin D supplementation and fewer kidney stones – meta-analysis of RCT Sept 2016
- Overview Kidney Stones and vitamin D
- Kidney Stones are related to poor genes – example of CYP24A1 (Vitamin D) – Nov 2019
- Kidney stones Vitamin D myth from medical book - 2010
- Kidney stone production REDUCED in rats when Vitamin D and Calcium was added – Dec 2013
- Kidney stones independant of vitamin D levels in range 20-100 ng – Oct 2013
Genetic polymorphisms have been suggested as risk factors affecting the occurrence and recurrence of kidney stones, although findings regarding the latter remain inconclusive. We performed this systematic review and meta-analysis to clarify the associations between genetic polymorphisms and recurrent kidney stones. PubMed, SCOPUS, EMBASE, and Cochrane Library databases were searched through May 28th, 2020 to identify eligible studies. The Quality in prognostic studies (QUIPS) tool was used to evaluate bias risk. Allelic frequencies and different inheritance models were assessed. All analyses were performed using Review manager 5.4.
A total of 14 studies were included for meta-analysis, assessing urokinase (ApaL1) and vitamin D receptor (VDR) (ApaI, BsmI, FokI, and TaqI) gene polymorphisms. The
- ApaLI polymorphism demonstrated protective association in the recessive model [odds ratio (OR) 0.45, P < 0.01]
- albeit higher risk among Caucasians in the heterozygous model (OR 16.03, P < 0.01).
- The VDR-ApaI polymorphism showed protective association in the dominant model (OR 0.60, P < 0.01).
- Among Asians, the
- VDR-FokI polymorphism recessive model showed significant positive association (OR 1.70, P < 0.01) and the
- VDR-TaqI polymorphism heterozygous model exhibited protective association (OR 0.72, P < 0.01).
- The VDR-BsmI polymorphism was not significantly associated with recurrent kidney stones in any model.
- Urokinase-ApaLI (recessive model),
- VDR-ApaI (dominant model), and
- VDR-TaqI (heterozygous model) polymorphisms were associated with decreased recurrent kidney stone risk
whereas urokinase-ApaLI (heterozygous model) and VDR-FokI polymorphisms were associated with increased risk among Caucasians and Asians, respectively. These findings will assist in identifying individuals at risk of kidney stone recurrence.