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Diabetes and gout both predispose patients to nephrolithiasis. Sodium–glucose cotransporter-2 (SGLT-2) inhibitors, which promote both uric acid excretion and urinary flow, have been associated with lower risks for kidney stones and gout attacks in observational studies (NEJM JW Gen Med Mar 15 2024 and JAMA Intern Med 2024; 184:265; NEJM JW Gen Med Aug 15 2023 and Ann Intern Med 2023 Aug; 176:1067). Risk for recurrent nephrolithiasis with these drugs has not been studied extensively.
In this latest observational study using Canadian population databases, researchers identified 20,000 adults with diabetes and previous nephrolithiasis who initiated SGLT-2 inhibitors (14,000 patients) or glucagon-like peptide-1 (GLP-1) receptor agonists (6000 pa…