Sodium-Glucose Cotransporter 2 Inhibitors May Lower Kidney Stone Risk in People with Diabetes: A Global Real-World Comparison

SGLT2 inhibitors are associated with a lower risk of nephrolithiasis compared to other diabetes medications.

• SGLT2 inhibitor use was linked to a nephrolithiasis incidence of 1.5%, compared to 1.9% for dipeptidyl peptidase-4 inhibitors and 1.6% for glucagon-like peptide-1 receptor agonists.
• The hazard ratios indicated a reduced risk of nephrolithiasis with SGLT2 inhibitors (HR 0.825 vs. DPP4i; HR 0.812 vs. GLP1-RA), with statistical significance (p < 0.001).
• Protective effects of SGLT2 inhibitors were consistent across various patient demographics, including age, glycemic control, body mass index, and renal function.
• The association between SGLT2 inhibitors and reduced risk of nephrolithiasis was slightly weaker in older adults and those with impaired renal function.

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