Objective: This study aimed to investigate urinary tract infections (UTIs) and associated risk factors in patients with type 2 diabetes mellitus and chronic kidney disease (CKD), with or without treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i). Methods: We retrospectively analyzed diabetic CKD patients with available urine culture results. Patients were divided into two groups: those receiving SGLT2i therapy and those not receiving it. The groups were compared retrospectively with respect to the development of urinary tract infection at 12-month follow-up, using clinical and laboratory results. Results: A total of 151 patients with T2DM were included, with a median age of 70 years (range: 61–76), and 84 (56%) were female. Among them, 91 (60%) patients were treated with SGLT2i. BMI, plasma glucose levels, and the urine protein/creatinine ratio were significantly lower in the SGLT2i group (p = 0.002, p = 0.049, and p < 0.001, respectively), while serum urea and creatinine levels were significantly higher (p = 0.048 and p = 0.028, respectively). A total of 59 patients (39.1%) had positive urine cultures, 32 of whom (35.2%) were using SGLT2i. There was no statistically significant difference in UTI incidence between SGLT2i users and non-users (p = 0.298). Among patients with positive cultures, Escherichia coli was the most common pathogen, identified in 52.5% (n = 31) of cases. Patients with positive urine cultures were older (p = 0.005), and 39 (66%) were female (p = 0.038). According to logistic regression analysis, advanced age and female sex were identified as independent risk factors for UTI (p = 0.037; Odds Ratio = 2.172, 95% CI: 1.048–4.502 and p = 0.033; Odds Ratio = 2.169, 95% CI: 1.065–4.415, respectively). Conclusions: In diabetic patients with CKD, the use of SGLT2i reduces proteinuria without increasing the risk of urinary tract infections. Advanced age and female sex are independent risk factors for UTI.
Yavuz et al. (Thu,) studied this question.