Using data from the NHANES survey, Stanford researchers found that….
Researchers from the Stanford University School of Medicine observed data from the 2007-2010 National Health and Nutrition Examination Survey (NHANES). The survey found that patients with type-2 diabetes and a history of insulin use had a 2.4 times and 3.3 times risk of developing kidney stones, respectively.
When the model of the study was adjusted, the results revealed that patients with HbA1c values of 5.7%-6.4% and higher than 6.5%, had a 34% and 92% increase in their risk of developing kidney stones. In addition, patients with fasting plasma glucose (FPG) levels greater than 126 mg/dL were at a higher risk of kidney stones than subjects with FPG of less than 100 mg/dL.
The researchers measured insulin resistance by using fasting plasma insulin (FPI) levels and the homeostasis model assessment of insulin resistance (HOMA-IR). The highest tertiles of FPI and HOMA-IR had a 28% and 51% increased risk of kidney stones, respectively, when compared with the lowest tertiles of both measures. After adjusting for patient factors, the study concluded that a history of type 2 diabetes, insulin use, FPI, and HbA1c are significantly associated with kidney stone disease.
The researchers observed an increase in urinary calcium and phosphorous excretion in type 2 diabetic patients. The researchers noted, "Hyperglycemia and its resultant glycosuria have been implicated in altered renal handling of calcium, phosphorus, and uric acid." This suggests that glucose control has an association with the pathophysiology of kidney stone disease. Hopefully in the future, we can optimize glucose control in type 2 diabetics and prevent kidney stone disease.
Published online ahead of print in European Urology, April 10, 2013.