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Sodium-Glucose Cotransporter 2 Inhibitors Tied to Lower Kidney Stone Risk

Findings seen compared with glucagon-like peptide 1 receptor agonists or dipeptidyl peptidase 4 inhibitors

By Lori Solomon HealthDay Reporter

THURSDAY, Feb. 8, 2024 (HealthDay News) — For adults with type 2 diabetes, initiation of sodium-glucose cotransporter 2 inhibitors (SGLT2is) may lower the risk for nephrolithiasis, according to a study published online Jan. 29 in JAMA Internal Medicine.

Julie M. Paik, M.D., Sc.D., M.P.H., from Brigham and Women s Hospital in Boston, and colleagues examined the association between SGLT2is and the risk for developing nephrolithiasis in patients with type 2 diabetes. The analysis included 358,203 propensity-matched pairs initiating an SGLT2i or a glucagon-like peptide 1 receptor agonist (GLP-1RA) and 331,028 propensity-matched pairs initiating an SGLT2i or a dipeptidyl peptidase 4 inhibitor (DPP4i).

The researchers found that during a median follow-up of 192 days, the risk for nephrolithiasis was lower in patients initiating an SGLT2i versus those initiating a GLP-1RA (14.9 versus 21.3 events per 1,000 person-years; hazard ratio [HR], 0.69; rate difference [RD], −6.4) or a DPP4i (14.6 versus 19.9 events per 1,000 person-years; HR, 0.74; RD, −5.3). Similar associations between SGLT2i use and nephrolithiasis risk were seen by sex, race and ethnicity, history of chronic kidney disease, and obesity. Among adults aged younger than 70 years, the magnitude of the risk reduction with SGLT2i use was larger than for those aged 70 years or older (HR, 0.85; RD, −3.46 per 1,000 person-years).

“Our findings could help inform clinical decision-making for patients with diabetes who are at risk for developing kidney stones,” Paik said in a statement.

Several authors disclosed ties to industry.

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