A comparison of the metabolic profiles of diabetic and non-diabetic uric acid stone formers

Abstract

E190Cite as: Can Urol Assoc J 2013;7:E190-2. http://dx.doi.org/10.5489/cuaj.11133 Epub 2012 Mar 2. AbstractIntroduction: The aim of this study was to compare the metabolic profiles of diabetic and non-diabetic patients with uric acid stones to understand whether preventive strategies should be tailored to reflect different causative factors. Methods:The results of the metabolic evaluation of patients with uric acid stones identified prospectively from the Metabolic Stone Clinic at St. Joseph's Hospital, London, Canada were reviewed. Information included patients' clinical histories, 24 hour urine collections, blood chemistry and stone analysis. Results: Complete data were obtained from 68 patients with uric acid stones. Twenty-two patients had diabetes. There were no statistically significant differences in mean age, body mass index, or history of gout. Among diabetics, pure uric acid stones were identified in 14 patients (63%) and mixed uric acid in 8 (36%). Pure uric acid stones were more common in the diabetic cohort (63% vs. 46%, p = 0.16). Urine pH, serum and urine uric acid levels and 24-hour urine volumes were similar in both groups. The diabetic group had an increased average oxalate excretion (424 μmol/d vs. 324 μmol/d, p = 0.003). Conclusion:The exact etiological basis for the higher oxalate excretion in diabetic uric acid stone formers is unclear. Whether this is a metabolic feature of diabetes, due to dietary indiscretion or the iatrogenic consequence of dietary advice requires further investigation.

Associations between BMI, serum uric acid, serum glucose, and blood pressure with urinary tract stone opacity

“…These conditions lead to increased risks of uric acid and calcium stone formation. 6,8,9 Urolithiasis as renal manifestations in gout patients usually is due to low urine pH. 10 Several studies have shown association between recurrent uric acid kidney stones and metabolic syndrome.…”