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Background: In the past few decades, the prevalence of kidney stones in Western countries has increased in parallel with the growing overweight/obesity and type 2 diabetes mellitus rates. An increased insulin resistance in these patients explains, in part, the rising prevalence of uric acid stones.

Aim: The Aim of this retrospective study was to evaluate the metabolic abnormalities in type 2 diabetic and non-diabetic patients with kidney stones.

Methods: A total of 104 diabetic patients (age: 57.8 ± 11 years) and 130 non-diabetics (age: 52.1 ± 6.7 years) with kidney stones were selected.

Results: Higher rates of body mass index, hypertension, urinary tract infection, gout and hyperuricemia were observed in diabetic patients as compared to the non-diabetics, while similar rates were found for their family history of kidney stones. Metabolic abnormalities were detected in 95.2% and 81.5% of diabetics and non-diabetics, respectively. Idiopathic hypercalciuria was the most frequent abnormality in both groups, although as a simple abnormality, in diabetic patients, unduly acidic urine was the more common.

Conclusions: unduly acidic urine is the most frequent single abnormalities in patients with diabetes mellitus and is in part responsible for the greater number of uric acid stones.