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Nephrolithiasis and sodium-glucose co-transporter-2 (SGLT-2) inhibitors: A meta-analysis of randomized controlled

Claudia Cosentino1, Ilaria Dicembrini1, Besmir Nreu1

  • 1Diabetology, Careggi Hospital and University of Florence, Italy.

Diabetes Research and Clinical Practice
|August 12, 2019
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) lower uric acid in type 2 diabetes. However, this meta-analysis found no increased risk of kidney stones (nephrolithiasis) with SGLT2i use in patients with type 2 diabetes.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are used to treat type 2 diabetes.
  • SGLT2i have been observed to lower serum uric acid levels.
  • Hyperuricemia is a known risk factor for nephrolithiasis (kidney stones).

Purpose of the Study:

  • To evaluate the effect of SGLT2 inhibitors on the risk of nephrolithiasis.
  • To analyze data from clinical trials comparing SGLT2i with placebo or active treatments.

Main Methods:

  • Meta-analysis of randomized controlled trials.
  • Included trials had a minimum duration of 52 weeks.
  • Compared SGLT2 inhibitors against placebo or active comparators.

Main Results:

  • SGLT2 inhibitors demonstrated a reduction in serum uric acid levels.
  • The meta-analysis did not find a significant effect of SGLT2 inhibitors on the risk of nephrolithiasis.
  • No increased incidence of kidney stones was observed with SGLT2i treatment.

Conclusions:

  • Despite lowering uric acid, SGLT2 inhibitors do not appear to increase the risk of nephrolithiasis.
  • SGLT2i can be safely used in type 2 diabetes patients, even those at risk for kidney stones.
  • Further research may explore specific patient subgroups or long-term effects.
Keywords:
HyperuricemiaMeta-analysisNephrolithiasisSGLT-2 inhibitors

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