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Nephrolithiasis against type 2 diabetes mellitus: on the effect of hypoglycemic therapy on lithogenesis

S K Yarovoy1,2, E N Kareva3, O V Djalilov1

  • 1N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Center of Radio-logy, Ministry of Health of Russia, Moscow, Russia.

Terapevticheskii Arkhiv
|February 1, 2019
PubMed
Abstract

Insights

Oral hypoglycemic agents impact urine properties in patients with type 2 diabetes and nephrolithiasis. Metformin may increase urate stone risk, while canagliflozin shows a potentially neutral effect on recurrence.

Area of Science:

  • Nephrology
  • Endocrinology
  • Urology

Background:

  • Recurrent nephrolithiasis is a significant concern, particularly in patients with type 2 diabetes mellitus.
  • Understanding the influence of diabetes medications on stone formation is crucial for patient management.

Purpose of the Study:

  • To investigate the effects of various oral hypoglycemic agents on urine characteristics relevant to nephrolithiasis recurrence.
  • To compare the impact of metformin, glibenclamide, and canagliflozin on urine pH and composition in diabetic patients with kidney stones.

Main Methods:

  • A study involving 315 patients with recurrent nephrolithiasis and type 2 diabetes mellitus.
  • Patients were categorized into groups receiving metformin, glibenclamide, canagliflozin, or insulin therapy (control).
  • Analysis of urine properties, including pH and diuresis, in relation to the administered antidiabetic medication.

Main Results:

  • Metformin was associated with a decrease in urine pH, potentially increasing the risk of urate nephrolithiasis.
  • Glibenclamide caused minor, clinically insignificant changes in urine pH.
  • Canagliflozin increased diuresis and uric acid excretion but did not significantly alter urine pH, potentially mitigating urate stone recurrence risk.

Conclusions:

  • Drug therapy for type 2 diabetes mellitus significantly influences urine properties in patients with nephrolithiasis.
  • The choice of oral hypoglycemic agent can impact the risk of recurrent kidney stone formation, particularly urate stones.
Keywords:
diabetes mellitus type 2hypoglycemic therapymetaphylaxis nephrolithiasisnephrolithiasis

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