Abstract
Uric acid urolithiasis constitutes approximately 7–10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in patients with uric acid stones. Ninety-nine patients from a single medical center, who had a uric acid component in their stone specimen were enrolled and their medical records were reviewed retrospectively between January 2010 and December 2016. All patients were divided into gout and non-gout groups. Gout was confirmed in 24 patients in this study (24.2%). The proportion of DM was significantly higher in the non-gout group (34.7%) than in the gout group (4.3%, p < 0.05). Renal function was decreased and serum triglyceride was higher in patients with gout. Uric acid urolithiasis patients with DM had a lower risk for gout (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). In 89 patients with predominant uric acid stones (>50% uric acid composition), the risk for gout was still lower in patients with diabetes than non-diabetes (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). These findings suggest that decreased risk of gout is found in uric acid urolithiasis patients with diabetes. Our results imply that patients with uric acid stones should have complete diabetes evaluation before the administration of uric acid controlling medication.
Highlights
Uric acid is a waste product of purine metabolism; it is a common component of urinary stones
We sought to characterize the serum biochemical features and concomitant metabolic syndrome in uric acid stone formers with and without gout, and whether there is a difference in the associated risk of gout between diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis
We examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in uric acid stone formers
Summary
Uric acid is a waste product of purine metabolism; it is a common component of urinary stones. The most common cause of hyperuricosuria is dietary imbalance, especially high amounts of purine meats, sugar (fructose), and beer [2] All of these foods increase the risk of gout. More evidence suggests that excessively acidic urine, which causes titration of urate to the highly insoluble uric acid, may be the key factor causing uric acid urolithiasis This feature of urine is believed to distinguish gout patients with or without urolithiasis. We sought to characterize the serum biochemical features and concomitant metabolic syndrome in uric acid stone formers with and without gout, and whether there is a difference in the associated risk of gout between diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. We examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in uric acid stone formers
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