higher prevalence of asymptomatic renal stones in diabetic population: do we need to screen routinely?

RIMI SOM SENGUPTA; UPAL SENGUPTA; SNEHASIS GHOSH; BISWAROOP SEAL; TAPAS KUMAR MONDAL

Volume : VI, Issue : V, May - 2017

higher prevalence of asymptomatic renal stones in diabetic population: do we need to screen routinely?

Rimi Som Sengupta, Upal Sengupta, Snehasis Ghosh, Biswaroop Seal, Tapas Kumar Mondal

Abstract :

Introduction: Worldwide, renal stone disease is an important cause for morbidity. This is true in case of symptomatic renal stone disease causing hospital admissions, healthcare expenditure as well as in case of asymptomatic renal stones. Asymptomatic renal stones are also a matter of serious concern due to their potential for causing symptomatic disease and silently causing kidney damage and progressing towards chronic kidney disease. Type 2 diabetes mellitus is a known risk factor for renal stone disease. In our cross–sectional study, we investigated whether asymptomatic renal stone disease, which may be an additional risk factor for kidney damage is more prevalent in diabetic patients. Aims of the study: To test our hypothesis that, like symptomatic kidney stones, asymptomatic stones are also more prevalent in diabetic subjects as compared to matched non–diabetic controls. Materials and methods: In this cross sectional observational stud,123 diabetic patients were compared with 129 non–diabetic subjects on yhe basis of routine abdominal ultrasound for the diagnosis of asymptomatic kidney stones. Patients with any history of renal stone disease or any other kidney disease including diabetic nephropathy were excluded. Presence of any other micro or macro–vascular complication including coronary artery disease were also considered as exclusion criteria. Measurements of serum calcium, phosphorus, uric acid were also done. Statistical analysis was done by calculating the chi–square between the study groups. Result: Nearly nine percent (8.9%) subjects inside the diabetic group were found to have renal stones as compared to 2.3% (p< 0.05) subjects in the control group detected in ultrasonographic screening. Although obesity was more common in the diabetic group, it was not statistically significant. Mean serum calcium and uric acid levels were comparable in both the groups. Conclusion: On the basis of the finding of our original investigation, we propose for routine ultrasonographic screening of diabetic patients for detecting asymptomatic renal stones. Although the long–term benefit of such intervention will only be proved by an interventional study.