Evaluating HbA1c, BMI and Urinary Biochemistry as Risk Factors for Renal Tract Stones (Urolithiasis
Keywords:
Urolithiasis, HbA1c, BMI, , Urinary parameters, Renal stones, Lithotripsy, Metabolic factorsAbstract
OBJECTIVE: To evaluate the role of HbA1c, BMI and urinary parameters as predictors of renal stone formation.
METHODOLOGY: This case-control study analyzed medical records of 300 patients with renal tract stones and 300 control subjects at the Ahmed Medical Complex in Rawalpindi from January to December 2024. Clinical data included demographics, BMI, HbA1c levels and urinary parameters (pH, citrate, Calcium). Statistical analysis was performed using t-tests, chi-square tests and logistic regression to identify significant predictors.
RESULTS: Patients with urolithiasis had significantly higher BMI (28.1 ± 3.6 kg/m²) and HbA1c (7.2 ± 1.4%) than controls (p < 0.001). Urinary calcium excretion was elevated while citrate levels and urinary pH were lower in patients (p<0.001). Logistic regression identified HbA1c ?6.5% (OR: 2.3, p<0.001) and BMI >25 (OR: 1.7, p=0.002) as significant predictors. Patients with uric acid stones exhibited higher HbA1c levels than patients with calcium oxalate stones.
CONCLUSION: Metabolic factors, particularly HbA1c and BMI, play a critical role in urolithiasis. Integrating glycemic control and weight management into preventive strategies could reduce the disease burden.
References
1. Ahmed A, Anwar M, Khan S, Ali R, Malik Z. Risk factors for urolithiasis in Pakistan: A clinical study. Pak J Med Sci. 2020; 36(3): 345-350.
2. Rams K, Philipraj SJ, Purwar R, Reddy B. Correlation of metabolic syndrome and urolithiasis: A prospective cross-sectional study. Urol Ann. 2020; 12(2): 144-149.
3. Koudonas A, Tsiakaras S, Tzikoulis V, Papaioannou M, de la Rosette J, Anastasiadis A et al. Lifestyle factors and the microbiome in urolithiasis: A narrative review. Nutrients. 2025; 17(3): 465.
4. Zhao E, Gao Y, Xiao R, Zhang C. Patterns of weight change during adulthood and incidence of nephrolithiasis: a population-based study. Int J Obes. 2024; 48(4): 461-468.
5. Waqas M, Khan ZA, Ahmad S, Akbar S, Khalid N. Risk factors of kidney stones in Khyber Pakhtunkhwa, Pakistan: a descriptive cross-sectional study. Cureus. 2024; 16(6): e63080. doi:10.7759/cureus.63080.
6. Ferraro PM, da Silva Cunha T, Curhan GC. Sex differences and the risk of kidney stones. Semin Nephrol. 2022; 42(2): 230-235.
7. Spasiano A, Letavernier E, Ferraro PM, Unwin RJ, Gambaro G. Kidney stone biology: insights from genetics. Nephrol Dial Transplant. 2025; gfaf062. doi: 10.1093/ndt/gfaf062.
8. Lancina JA, Madsen KM, Schwartz BF, Stoller ML. Gender-specific differences in urinary biochemical risk factors for nephrolithiasis. J Urol. 2001; 165(4): 1085-7.
9. Han S, Zhao S, Zhong R, Liu H, Liu L, Yan Y. An analysis of the burden of urolithiasis: differences between the global, China, India and the United States, with projections through 2050. Urolithiasis. 2025; 53(1): 32.
10. Li K, Luo Y, Mo Y, Shen J, Liu X, Li H. Association between vitamin D receptor gene polymorphisms and idiopathic hypocitraturia in a Chinese Bai population. Urolithiasis. 2019; 47(3): 235-242.
11. Beldar VG, Sidat PS, Jadhao MM. Ethnomedicinal plants used for treatment of urolithiasis in India: a review. Curr Tradit Med. 2022; 8(3): 46-82.
12. Yousuf F, Elahi W, Syed AZ, Kumar S, Sharif I, Ali A. Urinary clinical manifestation in type I and II diabetes: an observational study. J Pharm Neg Results. 2023; 14: 149-56.
13. Sarada B, Satyanarayana U. Urinary composition in men and women and the risk of urolithiasis. Clin Biochem. 1991; 24(6): 487-90.
14. Liu LH, Kang R, He J, Zhao SK, Li FT, Zhao ZG. Diabetes mellitus and the risk of urolithiasis: a meta-analysis of observational studies. Urolithiasis. 2015; 43(4): 293-301.
15. Zheng S, Hua T, Yin G, Zhang W, Wang X, Qi L et al. Metabolic dysfunction-associated fatty liver disease and risk of nephrolithiasis: a sizeable cross-sectional study. Front Endocrinol (Lausanne). 2025; 15: 1406065.
16. Jian Z, Huang Y, He Y, Jin X, Li H, Li S et al. Genetically predicted lifelong circulating 25(OH)D levels are associated with serum calcium levels and kidney stone risk. J Clin Endocrinol Metab. 2022; 107(3): e1159-66.
17. Lin BB, Lin ME, Huang RH, Hong YK, Lin BL, He XJ. Dietary and lifestyle factors for primary prevention of nephrolithiasis: a systematic review and meta-analysis. BMC Nephrol. 2020; 21(1): 267.
18. Haghighatdoost F, Sadeghian R, Clark CC, Abbasi B. Higher dietary acid load is associated with an increased risk of calcium oxalate kidney stones. J Ren Nutr. 2021; 31(5): 467-474.
19. Khan SR, Pearle MS, Robertson WG, Gambaro G, Canales BK, Doizi S, Traxer O, Tiselius HG. Kidney stones. Nat Rev Dis Primers. 2016; 2(1): 16008.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Journal of Liaquat University of Medical & Health Sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.
When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.
Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.

















