Mp26-20 Changes in 24-Hour Urine Parameters Associated With SGLT-2 Inhibitors and GLP-1 Receptor Agonists

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP26)1 May 2024MP26-20 CHANGES IN 24-HOUR URINE PARAMETERS ASSOCIATED WITH SGLT-2 INHIBITORS AND GLP-1 RECEPTOR AGONISTS Ryan Hsi, Sara Best, Mary Oerline, Joseph Crivelli, John Asplin, Naim Maalouf, John Hollingsworth, and Vahakn Shahinian Ryan HsiRyan Hsi , Sara BestSara Best , Mary OerlineMary Oerline , Joseph CrivelliJoseph Crivelli , John AsplinJohn Asplin , Naim MaaloufNaim Maalouf , John HollingsworthJohn Hollingsworth , and Vahakn ShahinianVahakn Shahinian View All Author Informationhttps://doi.org/10.1097/01.JU.0001009408.66023.77.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Emerging data suggests that sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 agonists (GLP1a) used in the treatment of diabetes and obesity may lower stone risk. To better understand why this may be, we sought to determine associated changes in 24-hour urine parameters among individuals with kidney stone disease receiving these agents. METHODS: Using Medicare claims from a cohort of beneficiaries who received 24-hour urine collections (Litholink) between January 2010 and December 2019, we identified a subset with diabetes who received prescriptions for SGLT2i or GLP-1a (but not both) within 6 months prior to receiving a 24-hour urine test. We excluded beneficiaries receiving thiazides, alkali citrate, allopurinol, thiazolidinediones, or fenofibrate, and those who had an inadequate urine collection. Individuals meeting inclusion and exclusion criteria were matched 1:5 to diabetic controls matched by age, sex, and year of collection. Then, we performed univariate comparisons between cases and controls across demographic and 24-hour urinary parameters. RESULTS: The analytic cohort included 124 cases and 620 controls receiving SGLT2i agents, and 374 cases and 1,870 controls receiving GLP1a agents (see Table 1). Compared to controls, SGLT2i use was associated with higher mean citrate (838mg vs 636mg) and volume (2.4L vs 2.0L) (each p<0.0001). Additionally, lower urine pH and higher urinary potassium, sulfate, and uric acid levels were observed in the SGLT2i group, without differences seen in other parameters including calcium and sodium. Supersaturations of calcium oxalate, calcium phosphate, but not uric acid, were significantly improved in SGLT2i users compared to controls. Compared to controls, GLP-1a use was associated higher mean citrate (659mg vs 592mg) (p<0.001), but not urinary volume. Additionally, we observed significant but marginally lower pH, higher values of sodium, uric acid, oxalate, and lower calcium phosphate supersaturation in the GLP-1a users compared to controls. CONCLUSIONS: Among diabetics, an increase in urinary citrate was observed with either use of SGLT2i and GLP1a. Additionally, SGLT2i was associated with clinically significant increases in urinary volume. Source of Funding: Supported by NIH R01DK121709 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e421 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ryan Hsi More articles by this author Sara Best More articles by this author Mary Oerline More articles by this author Joseph Crivelli More articles by this author John Asplin More articles by this author Naim Maalouf More articles by this author John Hollingsworth More articles by this author Vahakn Shahinian More articles by this author Expand All Advertisement PDF downloadLoading ...