Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes

Type 2 diabetes (T2D) is associated with an increased risk of kidney stones. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) might lower the risk of nephrolithiasis by altering urine composition. However, no studies have investigated the association between SGLT2i use and nephrolithiasis risk in patients receiving routine care in the US. After 1:1 propensity score matching, a total of 716 406 adults with T2D (358 203 pairs) initiating an SGLT2i or a GLP-1RA (mean [SD] age, 61.4 [9.7] years for both groups; 51.4%vs 51.2%female; 48.6%vs 48.5%male) and 662 056 adults (331 028 pairs) initiating an SGLT2i or a DPP4i (mean [SD] age, 61.8 [9.3] vs 61.7 [10.1] years; 47.4%vs 47.3%female; 52.6%vs 52.7%male) were included. Over a median follow-up of 192 (IQR, 88-409) days, the risk of nephrolithiasis was lower in patients initiating an SGLT2i than among those initiating a GLP-1RA (14.9 vs 21.3 events per 1000 person-years; HR, 0.69 [95%CI, 0.67-0.72]; RD, −6.4 [95%CI, −7.1 to −5.7]) or a DPP4i (14.6 vs 19.9 events per 1000 person-years; HR, 0.74 [95%CI, 0.71-0.77]; RD, −5.3 [95%CI, −6.0 to −4.6]) . These findings suggest that in adults with T2D, SGLT2i use may lower the risk of nephrolithiasis compared with GLP-1RAs or DPP4is and could help to inform…

AUTORE: Julie M. Paik,; Helen Tesfaye,; Gary C. Curhan, ; Heidi Zakoul; Deborah J.Wexler; Elisabetta Patorno.