Brief Report| Volume 25, ISSUE 3, 100351, March 2023

OXGR1 is a candidate disease gene for human calcium oxalate nephrolithiasis

Published:November 29, 2022DOI:



      Nephrolithiasis (NL) affects 1 in 11 individuals worldwide, leading to significant patient morbidity. NL is associated with nephrocalcinosis (NC), a risk factor for chronic kidney disease. Causative genetic variants are detected in 11% to 28% of NL and/or NC, suggesting that additional NL/NC-associated genetic loci await discovery. Therefore, we employed genomic approaches to discover novel genetic forms of NL/NC.


      Exome sequencing and directed sequencing of the OXGR1 locus were performed in a worldwide NL/NC cohort. Putatively deleterious, rare OXGR1 variants were functionally characterized.


      Exome sequencing revealed a heterozygous OXGR1 missense variant (c.371T>G, p.L124R) cosegregating with calcium oxalate NL and/or NC disease in an autosomal dominant inheritance pattern within a multigenerational family with 5 affected individuals. OXGR1 encodes 2-oxoglutarate (α-ketoglutarate [AKG]) receptor 1 in the distal nephron. In response to its ligand AKG, OXGR1 stimulates the chloride-bicarbonate exchanger, pendrin, which also regulates transepithelial calcium transport in cortical connecting tubules. Strong amino acid conservation in orthologs and paralogs, severe in silico prediction scores, and extreme rarity in exome population databases suggested that the variant was deleterious. Interrogation of the OXGR1 locus in 1107 additional NL/NC families identified 5 additional deleterious dominant variants in 5 families with calcium oxalate NL/NC. Rare, potentially deleterious OXGR1 variants were enriched in patients with NL/NC compared with Exome Aggregation Consortium controls (χ2 = 7.117, P = .0076). Wild-type OXGR1-expressing Xenopus oocytes exhibited AKG-responsive Ca2+ uptake. Of 5 NL/NC-associated missense variants, 5 revealed impaired AKG-dependent Ca2+ uptake, demonstrating loss of function.


      Rare, dominant loss-of-function OXGR1 variants are associated with recurrent calcium oxalate NL/NC disease.



      March 7, 2023

      March 2023: OXGR1 variants novel candidate disease gene for kidney stone disease

      Kidney stone disease affects approximately one in 11 people over their lifetime and recent research has shown that rare genetic variants contribute to 15 percent cases. That fraction is even higher among children. A team of researchers at Boston Children’s Hospital had reason to believe there might be additional genetic links not yet identified. Amar Majmundar, MD, PhD, a pediatric nephrologist and researcher, joins GenePod to discuss the results of a recent study identifying the variant OXGR1 as a novel candidate disease gene for kidney stone disease, which he and his colleagues published in the journal Genetics in Medicine.

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