Sodium–glucose cotransporter 2 inhibitors and risk of nephro
Sodium–glucose cotransporter 2 inhibitors (SGLT2Is) may reduce nephrolithiasis risk by increasing urine flow. We aimed to investigate whether initiation of SGLT2I was associated with reduced nephrolithiasis risk.

Researchers conducted an active-comparator new-user cohort study using the Danish health registries. Individuals aged more than 40 years initiating SGLT2Is or glucagon-like peptide-1 receptor agonists (GLP1 RAs) were followed from treatment initiation until an inpatient or outpatient diagnosis of nephrolithiasis, death, emigration or end of study. New users of SGLT2Is were matched 1:1 on propensity scores to new users of GLP1 RAs. In supplementary analyses, risk of recurrent nephrolithiasis was assessed in individuals with a history of nephrolithiasis before treatment initiation.

-- They identified 24,290 and 19,576 eligible users of SGLT2Is and GLP1 RAs, respectively.

-- After matching, 12,325 patient pairs remained. The median age was 61 years and median follow-up was 2.0 years.

-- The nephrolithiasis rate was 2.0 per 1000 person-years in SGLT2I initiators compared with 4.0 per 1000 person-years in GLP1 RA initiators, with a rate difference of -1.9 per 1000 person-years and an HR of 0.51.

-- For recurrent nephrolithiasis (n=731 patient pairs), the rate difference was -17 per 1000 person-years and the HR was 0.68.

Conclusively, initiation of treatment with SGLT2Is was associated with a clinically significant reduced risk of incident and recurrent nephrolithiasis.