medwireNews: Sodium-glucose cotransporter (SGLT)2 inhibitor treatment could lower the risk for incident and recurrent kidney stones in people with type 2 diabetes, suggest Danish study results.
The registry analysis included 12,325 individuals (median age 61 years) initiating an SGLT2 inhibitor in 2012–2018 who were matched with the same number of people initiating glucagon-like peptide (GLP)-1 receptor agonists based on propensity scores.
After a median follow-up of approximately 2 years in both cohorts, SGLT2 inhibitor users had a significant 49% lower risk for kidney stones compared with their GLP-1 receptor agonist-treated counterparts. The incidence rate was 2.0 per 1000 person–years in SGLT2 inhibitor users compared with 4.0 per 1000 person–years in GLP-1 receptor agonist users, resulting in a rate difference of 1.9 per 1000 person–years.
Similarly, Kasper Kristensen (University of Southern Denmark, Odense) et al found that SGLT2 inhibitor users had a significant 32% lower risk for recurrent kidney stones compared with those taking GLP-1 receptor agonists, with incidence rates of 36.4 and 53.4 per 1000 person–years, respectively.
“A likely mechanism to explain the reduced risk of nephrolithiasis with SGLT2 [inhibitor] use is increased urinary flow and dilution of urine due to osmotic diuresis,” suggest the investigators in Diabetologia.
“Awaiting replication in other populations, the possible preventive effect of SGLT2 [inhibitors] towards nephrolithiasis should be considered when prescribing an otherwise indicated second-line glucose-lowering treatment,” they conclude.
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