{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:09:24Z","timestamp":1793045364739,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec id=\"ab-ioi230092-4\"><jats:title>Importance<\/jats:title><jats:p>Type 2 diabetes (T2D) is associated with an increased risk of kidney stones. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) might lower the risk of nephrolithiasis by altering urine composition. However, no studies have investigated the association between SGLT2i use and nephrolithiasis risk in patients receiving routine care in the US.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230092-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the association between SGLT2i use and nephrolithiasis risk in clinical practice.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230092-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This new-user, active comparator cohort study used data from commercially insured adults (aged \u226518 years) with T2D who initiated treatment with SGLT2is, glucagon-like peptide 1 receptor agonists (GLP-1RAs), or dipeptidyl peptidase 4 inhibitors (DPP4is) between April 1, 2013, and December 31, 2020. The data were analyzed from July 2021 through June 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230092-7\"><jats:title>Exposure<\/jats:title><jats:p>New initiation of an SGLT2i, GLP-1RA, or DPP4i.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230092-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was nephrolithiasis diagnosed by <jats:italic>International Classification of Diseases<\/jats:italic> codes in the inpatient or outpatient setting. New SGLT2i users were 1:1 propensity score matched to new users of a GLP-1RA or DPP4i in pairwise comparisons. Incidence rates, rate differences (RDs), and estimated hazard ratios (HRs) with 95% CIs were calculated.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230092-9\"><jats:title>Results<\/jats:title><jats:p>After 1:1 propensity score matching, a total of 716\u202f406 adults with T2D (358\u202f203 pairs) initiating an SGLT2i or a GLP-1RA (mean [SD] age, 61.4 [9.7] years for both groups; 51.4% vs 51.2% female; 48.6% vs 48.5% male) and 662\u202f056 adults (331\u202f028 pairs) initiating an SGLT2i or a DPP4i (mean [SD] age, 61.8 [9.3] vs 61.7 [10.1] years; 47.4% vs 47.3% female; 52.6% vs 52.7% male) were included. Over a median follow-up of 192 (IQR, 88-409) days, the risk of nephrolithiasis was lower in patients initiating an SGLT2i than among those initiating a GLP-1RA (14.9 vs 21.3 events per 1000 person-years; HR, 0.69 [95% CI, 0.67-0.72]; RD, \u22126.4 [95% CI, \u22127.1 to \u22125.7]) or a DPP4i (14.6 vs 19.9 events per 1000 person-years; HR, 0.74 [95% CI, 0.71-0.77]; RD, \u22125.3 [95% CI, \u22126.0 to \u22124.6]). The association between SGLT2i use and nephrolithiasis risk was similar by sex, race and ethnicity, history of chronic kidney disease, and obesity. The magnitude of the risk reduction with SGLT2i use was larger among adults aged younger than 70 years vs aged 70 years or older (HR, 0.85 [95% CI, 0.79-0.91]; RD, \u22123.46 [95% CI, \u22124.87 to \u22122.05] per 1000 person-years; <jats:italic>P<\/jats:italic> for interaction &amp;amp;lt;.001).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230092-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These findings suggest that in adults with T2D, SGLT2i use may lower the risk of nephrolithiasis compared with GLP-1RAs or DPP4is and could help to inform decision-making when prescribing glucose-lowering agents for patients who may be at risk for developing nephrolithiasis.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2023.7660","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T17:32:00Z","timestamp":1706549520000},"page":"265","source":"Crossref","is-referenced-by-count":50,"title":["Sodium-Glucose Cotransporter 2 Inhibitors and 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