New serious complication of diabetes mellitus -urolithiasis: issues of epidemiology and etiopathogenesis
Aim. To study the role of diabetes mellitus (DM) as one of the risk factors for urolithiasis (IBD), to consider the epidemiology of the clinical form of the combination of ICD and diabetes, to identify metabolic disorders that contribute to the formation of urinary stones in diabetes. Material and methods. The frequency of diabetes in patients with ICD in the Perm region for 30 years, from 1988 to 2017 was studied. For this purpose, 9865 ICD patients were examined in a urological hospital and preventive examinations of the urban and rural population of 8 territories were carried out with a coverage of 11,113 people. The medical history and outpatient maps of 1475 patients with the clinical form of combination of diabetes and ICD were studied. Type 1 diabetes had 427 patients, 2 types - 1048 (71.7%). Urine stones were studied by infrared spectroscopy in 182 patients, standard methods in 960. In 614 patients urine pH was measured, in 64 patients a complex evaluation of metabolic disorders leading to the formation of urinary stones was performed. Results and discation. It was established that the percentage of DM patients steadily increases among ICD patients, from 6.6% in 1988 to 16.2% in 2017. In medical examinations, diabetes combined with ICD was detected in 14% of cases. Stones formed with SD are most often (in 40.2%) urate, less often (in 30.5%) calcium oxalate. Metabolic disorders in diabetes lead to the appearance of a sharply acidic urine reaction (pH 4.5-6.0), an increase in the level of uric acid and calcium in the blood and urine. Additional risk factors for MCH in patients with diabetes are obesity, hypertension, metabolic syndrome, hypercaloric nutrition and others. Conclusions. DM is one of the important endogenous causes of ICD.