Diabetes mellitus has been associated with an increased risk of kidney stone formation in a number of epidemiologic studies. 1 Taylor E.N. Stampfer M.J. Curhan G.C. Diabetes mellitus and the risk of nephrolithiasis. Kidney Int. 2005; 68: 1230-1235 Crossref PubMed Scopus (368) Google Scholar , 2 Meydan N. Barutca S. Caliskan S. et al. Urinary stone disease in diabetes mellitus. Scand J Urol Nephrol. 2003; 37: 64-70 Crossref PubMed Scopus (59) Google Scholar , 3 Lieske J.C. de la Vega L.S. Gettman M.T. et al. Diabetes mellitus and the risk of urinary tract stones: a population-based case-control study. Am J Kidney Dis. 2006; 48: 897-904 Abstract Full Text Full Text PDF PubMed Scopus (111) Google Scholar With the exception of a study from Turkey, 2 Meydan N. Barutca S. Caliskan S. et al. Urinary stone disease in diabetes mellitus. Scand J Urol Nephrol. 2003; 37: 64-70 Crossref PubMed Scopus (59) Google Scholar these data reflect the findings from a population of American adults, with presumably Western trends in diet and lifestyle. The present study not only provides additional evidence for the link between diabetes mellitus and kidney stone formation but also extends it to a large, Taiwanese cohort. It also reinforces the notion that nephrolithiasis is a reflection of systemic disease—an increased incidence of stone disease is seen in patients with diabetes mellitus, as well as other common systemic conditions, such as metabolic syndrome and hypertension. 4 West B. Luke A. Durazo-Arvizu R.A. et al. Metabolic syndrome and self-reported history of kidney stones: the National Health and Nutrition Examination Survey (NHANES III) 1988-1994. Am J Kidney Dis. 2008; 51: 741-747 Abstract Full Text Full Text PDF PubMed Scopus (201) Google Scholar , 5 Borghi L. Meschi T. Guerra A. et al. Essential arterial hypertension and stone disease. Kidney Int. 1999; 55: 2397-2406 Crossref PubMed Scopus (138) Google Scholar Urinary tract infection—an independent risk factor for stone disease—was also associated with stone formation in this study. 6 Abrahams H.M. Stoller M.L. Infection and urinary stones. Curr Opin Urol. 2003; 13: 63-67 Crossref PubMed Scopus (34) Google Scholar The authors noted a synergistic effect between urinary tract infection and diabetes mellitus in the risk of stone formation for women but not for men. It remains to be seen whether this is a reflection of true physiologic differences by gender or is artifactual. Increased Risk of Urinary Tract Calculi Among Patients With Diabetes Mellitus—A Population-based Cohort StudyUrologyVol. 79Issue 1PreviewTo investigate the inter-relationship among diabetes, urinary tract infection (UTI), and urinary tract calculi (UTC). Full-Text PDF ReplyUrologyVol. 79Issue 1PreviewThank you for your comment on our report about the increased risk of urinary tract calculi (UTC) among patients with diabetes mellitus. In our study, we observed that diabetes mellitus had an additive effect on the rate of UTC in women with urinary tract infection (UTI). Evidence from previous studies suggests that previous UTI was associated with asymptomatic bacteriuria1 and asymptomatic bacteriuria occurs more frequently in diabetic women than in nondiabetic women.2 In addition, several studies have documented citrate depletion in urine when Escherichia coli was added in various concentrations. Full-Text PDF