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Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers.

Abstract

PURPOSE

The epidemiological relationship between nephrolithiasis and type 2 diabetes mellitus is well-known. Patients with diabetes mellitus are at increased risk for nephrolithiasis and those with nephrolithiasis are at risk for diabetes mellitus. We examined 24-hour urine composition in stone formers with and without diabetes mellitus.

MATERIALS AND METHODS

We retrospectively reviewed a database of 462 stone forming patients to examine the relationship between hypertension and 24-hour urine composition. Multivariate linear regression models were adjusted for age, race, gender, body mass index, hypertension, relevant medications and 24-hour urine constituents.

RESULTS

On univariate analysis diabetic patients had significantly greater urine volume than nondiabetic patients (2.5 vs 2.1 l daily, p = 0.004). Those with diabetes mellitus also excreted less daily potassium (61.1 vs 68.8 mEq, p = 0.04), phosphate (0.84 vs 1.0 gm, p = 0.002) and creatinine (1405.5 vs 1562.8 mg, p = 0.03), and had significantly lower daily urine pH (5.78 vs 6.09, p <0.001) and CaP supersaturation (0.49 vs 1.20, p <0.001) than nondiabetic patients. On multivariate analysis compared to patients without diabetes mellitus those with type II diabetes mellitus had significantly lower urine pH (-0.34, 95% CI -0.48 to -0.21) and significantly greater urine oxalate (6.43 mg daily, 95% CI 1.26 to 11.60) and volume (0.38 l daily, 95% CI 0.13 to 0.64).

CONCLUSIONS

Results show that of stone formers patients with type II diabetes mellitus excrete significantly greater urinary oxalate and significantly lower urine pH than those without diabetes mellitus. These findings are important for treating nephrolithiasis since they may influence dietary counseling, medical management and stone prevention.

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  • Authors+Show Affiliations

    ,

    University of California-San Francisco, San Francisco, California, USA. eisnerbh@urology.ucsf.edu

    , ,

    Source

    The Journal of urology 183:6 2010 Jun pg 2244-8

    MeSH

    Diabetes Mellitus, Type 2
    Diabetic Nephropathies
    Female
    Humans
    Hydrogen-Ion Concentration
    Kidney Calculi
    Male
    Middle Aged
    Oxalates
    Retrospective Studies

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    20400141

    Citation

    Eisner, Brian H., et al. "Diabetic Kidney Stone Formers Excrete More Oxalate and Have Lower Urine pH Than Nondiabetic Stone Formers." The Journal of Urology, vol. 183, no. 6, 2010, pp. 2244-8.
    Eisner BH, Porten SP, Bechis SK, et al. Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers. J Urol. 2010;183(6):2244-8.
    Eisner, B. H., Porten, S. P., Bechis, S. K., & Stoller, M. L. (2010). Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers. The Journal of Urology, 183(6), pp. 2244-8. doi:10.1016/j.juro.2010.02.007.
    Eisner BH, et al. Diabetic Kidney Stone Formers Excrete More Oxalate and Have Lower Urine pH Than Nondiabetic Stone Formers. J Urol. 2010;183(6):2244-8. PubMed PMID: 20400141.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers. AU - Eisner,Brian H, AU - Porten,Sima P, AU - Bechis,Seth K, AU - Stoller,Marshall L, Y1 - 2010/04/18/ PY - 2009/09/18/received PY - 2010/4/20/entrez PY - 2010/4/20/pubmed PY - 2010/6/4/medline SP - 2244 EP - 8 JF - The Journal of urology JO - J. Urol. VL - 183 IS - 6 N2 - PURPOSE: The epidemiological relationship between nephrolithiasis and type 2 diabetes mellitus is well-known. Patients with diabetes mellitus are at increased risk for nephrolithiasis and those with nephrolithiasis are at risk for diabetes mellitus. We examined 24-hour urine composition in stone formers with and without diabetes mellitus. MATERIALS AND METHODS: We retrospectively reviewed a database of 462 stone forming patients to examine the relationship between hypertension and 24-hour urine composition. Multivariate linear regression models were adjusted for age, race, gender, body mass index, hypertension, relevant medications and 24-hour urine constituents. RESULTS: On univariate analysis diabetic patients had significantly greater urine volume than nondiabetic patients (2.5 vs 2.1 l daily, p = 0.004). Those with diabetes mellitus also excreted less daily potassium (61.1 vs 68.8 mEq, p = 0.04), phosphate (0.84 vs 1.0 gm, p = 0.002) and creatinine (1405.5 vs 1562.8 mg, p = 0.03), and had significantly lower daily urine pH (5.78 vs 6.09, p <0.001) and CaP supersaturation (0.49 vs 1.20, p <0.001) than nondiabetic patients. On multivariate analysis compared to patients without diabetes mellitus those with type II diabetes mellitus had significantly lower urine pH (-0.34, 95% CI -0.48 to -0.21) and significantly greater urine oxalate (6.43 mg daily, 95% CI 1.26 to 11.60) and volume (0.38 l daily, 95% CI 0.13 to 0.64). CONCLUSIONS: Results show that of stone formers patients with type II diabetes mellitus excrete significantly greater urinary oxalate and significantly lower urine pH than those without diabetes mellitus. These findings are important for treating nephrolithiasis since they may influence dietary counseling, medical management and stone prevention. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/20400141/Diabetic_kidney_stone_formers_excrete_more_oxalate_and_have_lower_urine_pH_than_nondiabetic_stone_formers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(10)00248-X DB - PRIME DP - Unbound Medicine ER -