Huang L, Shang Guan YW, Ji KK, Chen F. Identifying urosepsis risk in diabetic patients with renal and ureteral calculi: Key predictors and clinical implications. World J Diabetes 2025; 16(11): 114007 [DOI: 10.4239/wjd.v16.i11.114007]
Corresponding Author of This Article
Fang Chen, MD, PhD, Academic Fellow, Affiliate Associate Professor, Yancheng Key Laboratory of Molecular Epigenetics, Yancheng Medical Research Center of Nanjing University Medical School, The First People’s Hospital of Yancheng, No. 14 Yuehe Road, Tinghu District, Yancheng 224000, Jiangsu Province, China. jsdxchenfang@126.com
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Urology & Nephrology
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Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 14, 2025
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Publication Name
World Journal of Diabetes
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1948-9358
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Huang L, Shang Guan YW, Ji KK, Chen F. Identifying urosepsis risk in diabetic patients with renal and ureteral calculi: Key predictors and clinical implications. World J Diabetes 2025; 16(11): 114007 [DOI: 10.4239/wjd.v16.i11.114007]
World J Diabetes. Nov 15, 2025; 16(11): 114007 Published online Nov 15, 2025. doi: 10.4239/wjd.v16.i11.114007
Identifying urosepsis risk in diabetic patients with renal and ureteral calculi: Key predictors and clinical implications
Li Huang, Yu-Wen Shang Guan, Kang-Kang Ji, Fang Chen
Li Huang, Department of Urology, Binhai County People’s Hospital, Binhai Clinical College, Yangzhou University Medical College, Yancheng 224500, Jiangsu Province, China
Yu-Wen Shang Guan, Institute of Competitive Sports, Nanjing Institute of Physical Education, Nanjing 210000, Jiangsu Province, China
Kang-Kang Ji, Department of Clinical Medical Research, Binhai County People’s Hospital, Binhai Clinical College, Yangzhou University Medical College, Yancheng 224500, Jiangsu Province, China
Fang Chen, Yancheng Key Laboratory of Molecular Epigenetics, Yancheng Medical Research Center of Nanjing University Medical School, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu Province, China
Co-first authors: Li Huang and Yu-Wen Shang Guan.
Co-corresponding authors: Kang-Kang Ji and Fang Chen.
Author contributions: Huang L and Shang Guan YW advanced the primary argument of this letter; Chen F and Ji KK wrote the manuscript; Huang L and Shang Guan YW collected critical opinions; Chen F and Ji KK contributed to the revised version. All authors have read and approved the final manuscript. Huang L and Shang Guan YW contributed equally to this work as co-first authors. Chen F spearheaded the development of this manuscript by refining its core arguments, coordinating scholarly discussions among co-authors, and providing comprehensive oversight during the peer review and revision processes. Ji KK made substantial contributions to manuscript drafting, critical editing, and the solicitation/integration of expert feedback. Chen F and Ji KK jointly established the conceptual framework and logical structure of this manuscript. Given their complementary and indispensable contributions-Chen F in strategic direction and intellectual synthesis, and Ji KK in scholarly writing and academic networking-along with their shared leadership in determining the research focus and manuscript architecture, dual corresponding authorship is both scientifically justified and operationally essential. This designation fully adheres to established principles of research equity and academic integrity.
Supported by National Natural Science Foundation of China, No. 82300780; Natural Science Foundation of Jiangsu Province, No. BK20220306; and Yancheng Key Research and Development Plan (Social Development) Project, No. YCBE202214.
Conflict-of-interest statement: There are no potential conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Chen, MD, PhD, Academic Fellow, Affiliate Associate Professor, Yancheng Key Laboratory of Molecular Epigenetics, Yancheng Medical Research Center of Nanjing University Medical School, The First People’s Hospital of Yancheng, No. 14 Yuehe Road, Tinghu District, Yancheng 224000, Jiangsu Province, China. jsdxchenfang@126.com
Received: September 10, 2025 Revised: October 4, 2025 Accepted: October 27, 2025 Published online: November 15, 2025 Processing time: 66 Days and 1.7 Hours
Abstract
In their retrospective study of 298 diabetic patients with renal/ureteral calculi, Zhou et al identified critical predictors for urosepsis using multivariate logistic regression. Key findings revealed female gender (OR = 2.237, P = 0.03), advanced age (OR = 1.05/year, P = 0.002), fever (OR = 2.999, P = 0.015), severe hydronephrosis (OR = 6.129, P = 0.011), and elevated urinary markers-particularly urine leukocytes (U-LEU+++: OR = 66.0, P < 0.001) and glucose (U-GLU+++: OR = 7.248, P = 0.005) as independent risk factors. These readily accessible clinical parameters offer significant potential for early risk stratification in high-risk populations. While this STROBE-adherent study provides actionable insights, limitations include its single-center design and unaddressed antibiotic protocols. Future multicenter validation should assess residual stone impacts and optimize intervention thresholds. This work establishes a foundation for targeted surveillance protocols in diabetic urolithiasis management.
Core Tip: This letter synthesizes pivotal insights from Zhou et al's landmark investigation (n = 298) examining urosepsis predictors in diabetic urolithiasis. Crucially, bedside-accessible metrics-severe hydronephrosis (OR = 6.129), pyuria (U-LEU+++: OR = 66.0), and glycosuria (U-GLU+++: OR = 7.248)-demonstrably outstrip demographic factors in risk stratification efficacy. Our analysis underscores the necessity for urinalysis-guided triage protocols in acute care settings, while advocating multicenter validation of residual stone burden implications and antimicrobial strategies. Collectively, this work establishes a low-resource surveillance framework applicable to global diabetic populations.
