Diabetes Medication Class Tied to Lower Risk of Kidney Stones

Mass General Brigham researchers found that among patients with type 2 diabetes, those who began taking SGLT2 inhibitors had lower rates of kidney stones compared to patients who began taking other classes of diabetes medications.

Rates of kidney stones are on the rise in the United States and around the world. Type 2 diabetes is associated with increased risk of kidney stones, but some forms of treatment for this condition may also have the benefit of lowering risk of kidney stones. In a study led by investigators from Mass General Brigham, researchers found that there was an association between the use of sodium-glucose contratransporter 2 (SGLT2) inhibitors and a lower risk of developing kidney stones. Their findings are reported in JAMA Internal Medicine.

Researchers from Brigham and Women’s Hospital and Massachusetts General Hospital, founding members of the Mass General Brigham healthcare system, worked together to conduct the analysis. The study included data from three nationwide databases of patients with type 2 diabetes who were seen in routine clinical practice. The team analyzed information from 716,406 adults with type 2 diabetes who had started taking an SGLT2 inhibitor or two other classes of diabetes medications known as GLP1 receptor agonists or dipeptidyl peptidase 4 (DPP4) inhibitors. Patients who began taking SGLT2 inhibitors had a 30 percent lower risk of developing kidney stones than those taking GLP1 agonists and about a 25 percent lower risk than those taking DPP4 inhibitors. The findings were consistent across sex, race/ethnicity, history of chronic kidney disease and obesity.

“Our findings could help inform clinical decision making for patients with diabetes who are at risk for developing kidney stones,” said corresponding author Julie Paik, MD, ScD, MPH, of the Division of Pharmacoepidemiology and Pharmacoeconomics and the Division of Renal (Kidney) Medicine at Brigham and Women’s Hospital.

Authorship: Additional Mass General Brigham authors include Helen Tesfaye (BWH) Gary C. Curhan (BWH), Heidi Zakoul (BWH), Deborah J. Wexler (MGH) and Elisabetta Patorno (BWH).

Disclosures: Curhan reported receiving personal fees as an employee of OM1 Inc, royalties from UpToDate and grants from GlaxoSmithKline outside of the submitted work. Wexler reported receiving personal fees from Novo Nordisk outside of the submitted work. Patorno reported receiving grants to her institution from Boehringer Ingelheim outside of the submitted work.

Funding: This study was funded by the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, the National Institute of Aging (K08AG055670) the Patient-Centered Outcomes Research Institute (DB-2020C2-2036), the US Food and Drug Administration (5U01FD007213), and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR075117).

Paper cited: Paik JM et al. “Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes” JAMA Internal Medicine DOI: 10.1001/jamainternmed.2023.7660