HLA IN PATIENTS WITH UROLITHIASIS AS PREDICTORS OF THE RISK OF ITS OCCURRENCE AND COURSE

ANNOTATION. Recent studies have demonstrated the presence of associations between some histocompatibility antigens — HLA and certain pathologies, therefore we consider it relevant to study them in urological patients suffering from urolithiasis (U). THE AIM OF THE STUDY is to determine the frequency of HLA distribution in patients with urolithiasis to identify their associative relationships as genetic risk factors for the disease and its possible complications. MATERIALS AND METHODS. The distribution of HLA antigens was studied using the standard microlymphocytotoxic test (Terasaki) in 96 patients (p) with U and 120 p with acute pyelonephritis, the comparison groups were patients with chronic proliferative cystitis (28 p), chronic prostatitis (290 p), prostatic sclerosis (54 p), benign prostatic hyperplasia (24 p); reference group — 350 healthy donors. Relative (RR≥2) and attributive (AR) risk of diseases were determined — etiological fraction according to the formula: σ=х–у/1–у, where x — antigen frequency in patients, y — frequency in healthy patients and was considered reliable if σ>0.1. RESULTS. It was shown that HLA-A11 in the patient’s phenotype is an antigen of absolute (σ=0.12, p=0.042), and HLA-B14 — of relative risk (σ=0.08, p=0.037) of U development. Antigen B27 is an additional risk factor for U due to the revealed tendency to a higher frequency of its occurrence compared to the norm (p=0.087). The protector of this disease is HLA-B35 (RR=0.38, p=0.047), B12 determines the tendency of protection against U (p=0.053). It was found that the same antigens that are identified as predictors of U significantly associated with the risk of developing pyelonephritis of bacterial etiology — A11 ((RR=4.0, p<0.001) and B14 (RR=3.8, p=0.007) as its etiological factors according to the AR (σ≥0.1); B27 was identified as an additional trend factor (p=0.094) of the occurrence of chronic cystitis, and the pre­sence of A2B27 in the HLA phenotype (p=0.054) increases the likelihood of deterioration of function and the formation of chronic kidney disease in patients with U. CONCLUSIONS. The identified predictors — A11, B14, (B27-tendency) and the protector B35 (B12-tendency) of U and its complications — pyelonephritis and impaired kidney function and chronic kidney disease with the progression of the pathology are considered additional markers for prediction and personalized treatment tactics for patients with U.