You are here

  • Home
  • Archive
  • Volume 8, Issue 1
  • Frailty predicts a higher risk of incident urolithiasis in 525 368 patients with diabetes mellitus: a population-based study

Article Text

Article menu

Download PDFPDF

XML
Pathophysiology/Complications
Frailty predicts a higher risk of incident urolithiasis in 525 368 patients with diabetes mellitus: a population-based study
  1. Chia-Ter Chao1,2,3,
  2. Jui Wang4,
  3. Jenq-Wen Huang5,6,
  4. Kuan-Yu Hung5,7,
  5. Kuo-Liong Chien4
  1. 1Nephrology division, Department of Internal Medicine, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
  2. 2Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan
  3. 3Geriatric and Community Medicine Research Center, National Taiwan University Hospital Beihu branch, Taipei, Taiwan
  4. 4Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
  5. 5Nephrology division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  6. 6Department of Internal Medicine, National Taiwan University Hospital Yun Lin Branch, Douliou, Yunlin, Taiwan
  7. 7Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
  1. Correspondence to Professor Jenq-Wen Huang; 007378{at}ntuh.gov.tw

Abstract

Objective Patients with diabetes have an increased risk for urolithiasis, but the associated risk factors remain an active area of research. We investigated whether frailty influenced the probability of patients with diabetes developing urolithiasis.

Research design and methods Using data from the Longitudinal Cohort of Diabetic Patients from 2004 to 2010, we identified those without and with frailty based on a validated, modified FRAIL scale. Patients were followed until they developed urolithiasis, and we used Kaplan-Meier and Cox proportional hazard regression analyses to examine the relationship between frailty, its severity, and the risk of urolithiasis, accounting for demographic profiles, comorbidities, frailty status changes over follow-up, and medications, with risk competition by mortality.

Results Among 525 368 patients with diabetes, 64.4% were not frail, while 28.5%, 6.6%, and 0.6% had 1, 2, and ≥3 FRAIL items at baseline. After 4.2 years of follow-up, 13.4% experienced incident urolithiasis. Cox proportional hazard regression analysis showed that patients with diabetes having at least one FRAIL criterion exhibited a significantly higher risk for urolithiasis compared with non-frail patients (for 1, 2, and ≥3 items, hazard ratio (HR)s: 1.04, 1.23, and 1.46; 95% confidence intervals (CIs) 0.99 to 1.09, 1.12 to 1.35, and 1.12 to 1.91, respectively). This increase in urolithiasis risk remained significant if we restricted analyses to renal stones or recurrent urolithiasis as the study outcomes.

Conclusions Frailty may pose a risk for incident urolithiasis in patients with diabetes. Treating frailty may potentially reduce their risk for urolithiasis.

  • chronic kidney disease
  • diabetes mellitus
  • frail phenotype
  • frailty
  • renal stone
  • urinary stone
  • urolithiasis
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000755

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors Study design: C-TC, JW, J-WH. Data analysis: C-TC, K-YH, JW. Article drafting: C-TC, JW, J-WH, K-YH, K-LC. All authors approved the final version of the manuscript.

    • Funding The study is financially sponsored by National Taiwan University Hospital and Ministry of Science and Technology, Taiwan (MOST 108-2314-B-002-055-).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The protocol of the current study was approved by the institutional review board of the National Taiwan University Hospital (NO. 201802063W), and its content adhered to the Declaration of Helsinki. Informed consent was waived for all participants as adjudicated by the review board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The data used to conduct this study are not for release per administrative regulation, but additional analystic results will be available on reasonable request.