The effect of SGLT2 inhibitors on kidney stones; a systematic review and meta-analysis

Abstract

Introduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are among the antidiabetic drugs with unclear relationship effect on kidney stones. Accordingly, this study aimed to investigate the relationship between SGLT2 inhibitors treatment and kidney calculi incidence using systematic review and meta-analysis. Materials and Methods: The PRISMA statement was used to write this systematic review and meta-analysis. Databases, including ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar, were used to access the resources without a lower time limit until November 5, 2023. Data analysis was conducted using STATA 14 software. Results: Results obtained from six studies with a total of 4963542 participants indicated that SGLT2 inhibitors administration reduced the possibility of kidney calculi in general (OR = 0.80, 95% CI: 0.72, 0.89), in men (OR = 0.92, 95% CI: 0.86, 0.98), and women (OR = 0.93, 95% CI: 0.89, 0.97). SGLT2 inhibitors treatment prevented kidney calculi in cross-sectional studies (OR = 0.92, 95% CI: 0.89, 0.96), cohort studies (OR = 0.71, 95% CI: 0.66, 0.77), RCT study (OR = 0.64, 95% CI: 0.48, 0.86), Japan (OR = 0.92, 95% CI: 0.89, 0.96), United States (OR = 0.72, 95% CI: 0.67, 0.76), Denmark (OR = 0.51, 95% CI: 0.37, 0.71), compared with DPP4i (OR = 0.74, 95% CI: 0.71, 0.77), compared with GLP1RA (OR = 0.62, 95% CI: 0.47, 0.82), compared with other antidiabetic drugs (OR = 0.92, 95% CI: 0.89, 0.96), and compared with placebo (OR = 0.64, 95% CI: 0.48, 0.86). Conclusion: Compared with placebo and other antidiabetic drugs, SGLT2 inhibitors reduce the risk of kidney calculi. However, considering the limited number of investigated studies, more studies in this field are required. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (CRD42023483132) and Research Registry (UIN: reviewregistry1743) websites.