Kidney stone disease is an urgent medical and social problem. Genetic factors play an important role in the disease development. This study aims to establish an association between polymorphisms in genes coding for proteins involved in calcium metabolism and the development of calcium urolithiasis in Russian population. In this case-control study, we investigated 50 patients with calcium urolithiasis (experimental group) and 50 persons lacking signs of kidney stone disease (control group). For molecular genetic analysis we used a previously developed gene panel consisting of 33 polymorphisms in 15 genes involved in calcium metabolism: VDR, CASR, CALCR, OPN, MGP, PLAU, AQP1, DGKH, SLC34A1, CLDN14, TRPV6, KLOTHO, ORAI1, ALPL, and RGS14. High-throughput target sequencing was utilized to study the loci of interest. Odds ratios and 95% confidence intervals were used to estimate the association between each SNP and risk of urolithiasis development. Multifactor dimensionality reduction analysis was also carried out to analyze the gene-gene interaction. We found statistically significant (unadjusted p-value < 0.05) associations between calcium urolithiasis and the polymorphisms in the following genes: CASR rs1042636 (OR = 3.18 for allele A), CALCR rs1801197 (OR = 6.84 for allele A), and ORAI1 rs6486795 (OR = 2.25 for allele C). The maximum OR was shown for AA genotypes in loci rs1042636 (CASR) and rs1801197 (CALCR) (OR = 4.71, OR = 11.8, respectively). After adjustment by Benjamini-Hochberg FDR we found only CALCR (rs1801197) was significantly associated with the risk of calcium urolithiasis development. There was no relationship between recurrent course of the disease and family history of urolithiasis in investigated patients. Thus we found a statistically significant association of polymorphism rs1801197 (gene CALCR) with calcium urolithiasis in Russian population.
The article presents a clinical case of the development of medullary nephrocalcinosis in the patient with Williams syndrome. First manifestations of nephrocalcinosis in the patient were detected during the first year of life and preserved until 8 years of age. According to the world literature, the development of hypercalcemia can occur in 40% of patients with Williams syndrome, 5% of patients develop nephrocalcinosis with further progression of renal dysfunction and development of kidney stone disease. The presented case demonstrates the necessity of differential diagnosis of nephrocalcinosis with inclusion of Williams syndrome into the list of diagnoses under consideration, as well as the problem of managing children with Williams syndrome, considering the possibility of the nephropathy development. A comprehensive approach to the management of patients with Williams syndrome should also include monitoring by a nephrologist. Such approach will enable timely prevention and avoid serious kidney complications in patients with Williams syndrome. Key words: Williams syndrome, hypercalcemia, hypercalciuria, nephrocalcinosis, kidney stone disease
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