MP27-18 DOES THIAZIDE PROPHYLAXIS FOR CALCIUM-BASED STONES INCREASE THE RISK OF NEW-ONSET DIABETES MELLITUS?

You have accessJournal of UrologyStone Disease: Therapy III1 Apr 2014MP27-18 DOES THIAZIDE PROPHYLAXIS FOR CALCIUM-BASED STONES INCREASE THE RISK OF NEW-ONSET DIABETES MELLITUS? John Knoedler, Amy Krambeck, John Lieske, Xujian Li, Eric Bergstralh, and Andrew Rule John KnoedlerJohn Knoedler More articles by this author , Amy KrambeckAmy Krambeck More articles by this author , John LieskeJohn Lieske More articles by this author , Xujian LiXujian Li More articles by this author , Eric BergstralhEric Bergstralh More articles by this author , and Andrew RuleAndrew Rule More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.381AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies involving thiazides and thiazide-type diuretics used to treat hypertension (HTN) have found an increased risk of new-onset diabetes mellitus. However, while thiazides and thiazide-type diuretics used for the prevention of calcium based urolithiasis have been found to be associated with impaired fasting glucose, their association with diabetes mellitus (DM) remains to be defined. Herein we evaluate the association of thiazides and thiazide-type diuretics (herein referred to as thiazides) used for calcium stone prophylaxis with new onset DM among incident stone formers. METHODS We retrospectively identified 2,350 incident stone formers with calcium-based stones in Olmsted County, Minnesota, from 1984-2011 using the Rochester Epidemiology Project. Patients with a diagnosis of DM or thiazide usage predating their stone event were excluded. Kaplan-Meier analysis predicted survival free from DM, while multivariate models compared the association of clinical variables with the development of DM. RESULTS 329 patients (14%) were treated with thiazides following incident stone, while 2,021 (86%) did not receive thiazides. Median age for those receiving thiazides was 46.5 years (IQR 37.0-57.2) compared to 38.4 years (IQR 29.7-49.8) for those not receiving thiazides (p<0.0001). Median follow up was 10 years (range 0.1-28 years). Incidence of new-onset DM 10 years after first stone event was 9.2% among the thiazide group, compared to 4.2% among the non-thiazide group (p<0.001). On multivariate analysis, use of thiazides (HR 1.73; p=0.007), increasing age (HR 1.03; p=0.002), and BMI at first stone event (HR 1.13; p<0.001) were associated with an increased risk of new-onset DM. The cohort of patients receiving thiazides after incident stone was then divided into those who received thiazides for HTN (n=248) and those who received thiazides for stone prophylaxis alone (n=81). On multivariate analysis thiazide administration for stone disease was not associated with new onset DM (HR 0.92; p=0.87). CONCLUSIONS While thiazide and thiazide-type diuretic usage among stone formers with HTN is associated with an increased risk of new-onset DM, thiazides used for stone prophylaxis alone did not increase the risk of new-onset DM. To our knowledge, this study is the first to evaluate the role of thiazides in the development of DM among a population of stone formers. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e280-e281 Advertisement Copyright & Permissions© 2014MetricsAuthor Information John Knoedler More articles by this author Amy Krambeck More articles by this author John Lieske More articles by this author Xujian Li More articles by this author Eric Bergstralh More articles by this author Andrew Rule More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Topic: Kidney Stones and Urolithiasis Treatments
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences