OBJECTIVE: To examine the differences in 24-hour urine composition between patients with and without diabetes mellitus (DM) in a large cohort of stone formers.
To examine differences in stone composition between patients with and without DM.
PATIENTS AND METHODS: A retrospective review of 1117 patients with nephrolithiasis and a 24-hour urinalysis was completed. Univariable analysis of 24-hour urine profiles and multivariable linear regression models were performed, comparing patients with and without DM. A subanalysis of patients with stone analysis data available was performed, comparing the stone composition of patients with and without DM.
RESULTS: Of the 1117 patients who comprised the study population, 181 (16%) had DM and 936 (84%) did not have DM at the time of urinalysis. Univariable analysis demonstrated significantly higher total urine volume, citrate, UA, sodium, potassium, sulfate, oxalate, chloride, and supersaturation (SS) of UA in individuals with DM (all p< 0.05). However, DM patients had significantly lower SS of calcium phosphate (CaP) and pH (all p< 0.05). Multivariable analysis showed that patients with DM had significantly lower urinary pH and SS CaP, but significantly greater citrate, UA, sulfate, oxalate, chloride, SS UA, SS calcium oxalate, and volume than patients without DM (all p< 0.05). Patients with DM had a significantly greater proportion of uric acid in their stones than patients without DM (50.2% vs. 13.5%, p< 0.001).
CONCLUSIONS: DM was associated with multiple differences on 24-hour urinalysis compared to those without DM, including significantly higher UA and oxalate, and lower pH. Control of urinary UA and pH, as well as limiting intake of dietary oxalate may reduce stone formation in patients with diabetes.
Written by:
Hartman C, Friedlander JI, Moreira DM, Elsamra SE, Smith AD, Okeke Z. Are you the author?
Hofstra North Shore-LIJ School of Medicine, The Arthur Smith Institute for Urology, New Hyde Park, NY, 11042, USA.
Reference: BJU Int. 2014 May 13. Epub ahead of print.
doi: 10.1111/bju.12807
PubMed Abstract
PMID: 24823472
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