SGLT2 inhibitors use tied to lower risk of kidney stones in patients with type 2 diabetes
USA: The use of SGLT2 inhibitors in adults with type 2 diabetes (T2D) may lower nephrolithiasis risk compared with GLP-1 receptor agonists or DPP4 inhibitors, a recent study has revealed.
The study findings, published in JAMA Internal Medicine, may help inform decision-making when prescribing glucose-lowering agents for patients at risk for developing nephrolithiasis.
The cohort study comprised 1 378 462 commercially insured adults with T2D initiated treatment with sodium-glucose cotransporter 2 inhibitors (SGLT2is), glucagon-like peptide 1 receptor agonists, or dipeptidyl peptidase 4 inhibitors. Those initiating SGLT2i treatment had a lowered risk of developing nephrolithiasis compared with those initiating the other two treatments.
There has been an increasing prevalence of kidney stones worldwide. Kidney stones are associated with substantial costs, cardiovascular disease, kidney function decline, and fractures. Type 2 diabetes is associated with an elevated risk of kidney stones.
SGLT2 inhibitors, a newer class of glucose-lowering agents with demonstrated renoprotective and cardiovascular benefits in clinical trials, might lower the risk of nephrolithiasis by altering urine composition and increasing urine volume. However, no studies have investigated the association between SGLT2i use and nephrolithiasis risk in patients receiving routine care in the US. To fill this knowledge gap, Julie M. Paik, Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues aimed to investigate the association between SGLT2i use and nephrolithiasis risk in clinical practice.
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