PD34-08 SODIUM-GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITORS ARE ASSOCIATED WITH A DECREASED RISK OF UROLITHIASIS COMPARED TO OTHER ANTIHYPERGLYCEMICS AMONG STONE-NAIVE DIABETICS

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD34-08 SODIUM-GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITORS ARE ASSOCIATED WITH A DECREASED RISK OF UROLITHIASIS COMPARED TO OTHER ANTIHYPERGLYCEMICS AMONG STONE-NAIVE DIABETICS Ridwan Alam, Jared Winoker, Brian Matlaga, and Naren Nimmagadda Ridwan AlamRidwan Alam More articles by this author , Jared WinokerJared Winoker More articles by this author , Brian MatlagaBrian Matlaga More articles by this author , and Naren NimmagaddaNaren Nimmagadda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003327.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Secondary analysis of pooled randomized controlled trials suggests that empagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), may reduce the risk of urolithiasis in diabetics by 38% when compared to placebo. We compared the risk of urolithiasis among stone-naïve diabetic patients prescribed SGLT2i versus other antihyperglycemics using a longitudinal, nationwide database. METHODS: TriNetX is a collaborative research enterprise with real-time data from over 70 healthcare organizations with more than 100 million patients. We queried the database for stone-naïve adult patients with type 2 diabetes mellitus between 1/1/2016 and 1/1/2021. Patients receiving SGLT2i therapy were compared against two groups: (1) patients receiving dipeptidyl peptidase 4 (DPP-4i) or glucagon-like peptide-1 receptor agonist (GLP-1-RA) and (2) all patients not receiving SGLT2i. Propensity score matching was performed on age, sex, race, hemoglobin A1c, glomerular filtration rate (GFR), and body mass index to control for confounding. The risk of urolithiasis was compared at 1, 3, and 5 years after initiation of therapy. RESULTS: SGLT2i was prescribed to 101,485 patients, DPP-4i or GLP-1-RA to 463,233 patients, and any non-SGLT2i to 3,924,446 patients. After matching, each group contained 101,484 patients. GFR was comparable among the groups at roughly 81 mL/min/1.73 m2 (P>0.10). The cumulative incidence of urolithiasis among patients prescribed SGLT2i was 1.06% at 1 year and increased up to 2.49% at 5 years [Table]. In comparison, patients prescribed DPP-4i or GLP-1-RA had a 43.9% increased risk of urolithiasis at 1 year, and this risk increased over time to 55.3% at 5 years (P<0.001). Patients managed with any non-SGLT2i therapy also had an increased risk of urolithiasis at all timepoints, ranging from 25.3% to 41.8% (P<0.001). GFR remained the highest in the SGLT2i group at all timepoints (P<0.001). CONCLUSIONS: Compared to other antihyperglycemics, SGLT2i is associated with the lowest risk of urolithiasis among diabetic patients without a prior history of stones. Renal function was best preserved in this group as well. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e923 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ridwan Alam More articles by this author Jared Winoker More articles by this author Brian Matlaga More articles by this author Naren Nimmagadda More articles by this author Expand All Advertisement PDF downloadLoading ...