A family history of kidney stone disease may predict earlier onset of kidney stones and an increased risk for recurrent kidney stones, with differences between maternal and paternal genetic inheritance, investigators reported at the AUA2021 Virtual Experience.
Any family history of kidney stone disease imparts an increased severity of urinary stone disease, Rei Unno, MD, PhD, of Nagoya City University Graduate School of Medical Sciences in Aichi, Japan told Renal & Urology News. The presence of a maternal relative with kidney stones may predict earlier onset of urolithiasis, he said.
In his team’s analysis of prospectively collected data from the Japanese Registry for Stones of the Kidney and Ureter (ReSKU), 603 of 1566 patients (38.5%) had a family history of urolithiasis. On multivariate analysis, any family history was significantly associated with 62% increased odds of recurrent stone events, 84% increased odds of first stone onset at or before the age of 30 years, and 54% increased odds of bilateral stones. A patient who had a first-degree relative with stone history had significant 58% increased odds stone recurrence and 42% increased odds of first stone onset. Having both a first- and a second-degree relative with stone history significantly associated with 2.2-fold increased odds for a recurrent stone event, 3.3-fold increased odds for early onset, and 1.9-fold increased odds of bilateral stones. Having a paternal or maternal relative with stone history significantly associated with 93% and 72% increased odds of recurrence and 1.5- and 2.9-fold increased odds of early onset, respectively.
“There is an association between mitochondrial dysfunction and kidney stone disease,” Dr Unno explained. “Maternal inheritance of abnormal mitochondrial DNA could contribute to the early stone development in patients with positive maternal family history of stones. In addition, maternal dietary habits have been shown to transmit to children more strongly than paternal dietary habits.”
“As there are many drivers associated with urolithiasis, we consider those with maternal relatives or multiple family members with kidney stone disease warrant closer follow-up, improvement of their diet, and aggressive stone prevention techniques to reduce the risk of urolithiasis,” Dr Unno said.
Unno R, Taguchi K, Usawachintachit M, et al. Maternal family history of urolithiasis is associated with earlier onset of urinary stone disease: results from ReSKU. Presented at: AUA2021 Virtual Experience held September 10-13, 2021. PD14-11.