Frailty predicts a higher risk of incident urolithiasis in 525 368 patients with diabetes mellitus: A population-based study
Journal
BMJ Open Diabetes Research and Care
Journal Volume
8
Journal Issue
1
Pages
e000755
Date Issued
2020
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. ? Author(s) (or their employer(s)) 2020.
SDGs
Other Subjects
Article; body mass; cerebrovascular disease; chronic obstructive lung disease; cohort analysis; comorbidity; controlled study; diabetes mellitus; follow up; frailty; human; hypertension; ICD-9-CM; incidence; lifestyle; longitudinal study; major clinical study; nephrolithiasis; peripheral vascular disease; prevalence; priority journal; risk factor; sensitivity analysis; smoking; urolithiasis; aged; complication; daily life activity; female; geriatric assessment; male; non insulin dependent diabetes mellitus; pathology; pathophysiology; prognosis; Taiwan; urolithiasis; Activities of Daily Living; Aged; Diabetes Mellitus, Type 2; Female; Follow-Up Studies; Frailty; Geriatric Assessment; Humans; Longitudinal Studies; Male; Prognosis; Risk Factors; Taiwan; Urolithiasis
Publisher
BMJ Publishing Group
Type
journal article