according to a recent study.
Type 2 diabetes is associated with excess risk for kidney stones. Sodium–glucose cotransporter-2 (SGLT-2) inhibitors increase urine output and alter urine composition in ways that might lower risk for kidney stones. In this U.S. study, researchers compared risks for kidney stones among 600,000 adults with type 2 diabetes who were new users of SGLT-2 inhibitors versus 600,000 propensity score–matched patients who initiated glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors, which do not have the same renal effects.
During median follow-up of 6 months, risk for kidney stones was significantly lower in patients who began using SGLT-2 inhibitors than in patients who began using GLP-1 receptor agonists (15 vs. 22 events/1000 person-years) or DPP-4 inhibitors (15 vs. 20 events/1000 person-years). The effect was larger for younger patients (age, 70).
This study suggests that initiating SGLT-2 inhibitors, compared with GLP-1 receptor agonists or DPP-4 inhibitors, is associated with lower risk for kidney stones in the short term; whether this effect will persist long term is unknown. For a patient in whom the decision to start an SGLT-2 inhibitor (vs. another diabetes drug) is otherwise a toss-up, a history of recurrent kidney stones might tip the balance toward the SGLT-2 inhibitor.
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