Abstract: TH-PO1087

Association of Hyperuricemia and Higher Uricosuria and the Development of Prediabetes or Diabetes in Kidney Stone Formers

Session Information

Category: Mineral Disease

  • 1204 Mineral Disease: Nephrolithiasis

Authors

  • Martinez-Guerra, Bernardo Alfonso, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Ramirez-Sandoval, Juan Carlos, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Castilla-Peón, María F, Hospital Infantil de Mexico Federico Gomez, Ciudad de México, Mexico
  • Gulias-Herrero, Alfonso, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Garcia, Cynthia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Background

Nephrolithiasis (NL) isassociated withinsulin resistance and may be a sentinel event before the diagnosis of diabetes mellitus (DM).

Methods

Demographics, associated medical conditions, laboratory data,including 24-h urine analysis, and treatment were obtained at least annually from records. We excluded from analysis KSF who were taking the following drugs that alter uric acid serum levels and excretion (thiazide diuretics, losartan, allopurinol).

Results

From 266 patients of the NL clinic, 118 non-diabetic KSF that fulfilled inclusion criteria were included, 73 (62%) were female, mean age 44±13 yrs, median baseline BMI 26 kg/m2(IQR 23-31) and 12 (10%) were hypertensive. Median follow-up was 8.6 years (range 1.4-19.3). During follow-up, preDMwas diagnosed in 27(23%) and DM in 24 (20%). Median time to DM diagnosis was 6.4 yrs (IQR 3.8-13). Bivariate analysis showed thatage, serum uric acid (≥5.5 in females and ≥7 mg/dL in males), and total excretion of uric acid (>310 mg/day in females and >390 mg/day in males in 3 or more 24-h urine analysis; see figure)were risk factors for development of preDMor DM. Other variables such as baseline BMI,eGFR, triglycerides, cholesterol, blood pressure or other 24-h urine profile determinations were not associated with the occurrence of the event. After adjusting for age, sex, and hyperuricemia (HR:2.2;95%CI:1.3-3.8), higher uric acid excretion (HR:8.7; 95%CI:1.2-65) was a strongprognostic factor for DM developmentin KSF patients.

Conclusion

The present study is the largest known report exploring the effect of 24-h urine analysis characteristics of KSDand the risk of development preDM andDM. Older age and hyperuricemia, predicted development of preDM and DMyet a higher 24-h urine uricosuriawas thestrongest predictor for this outcome even several years before the diagnosis of preDM or DM.