Evidence mapPaperPMID 41117521Full record

ArticleKidney3602026

Sodium-Glucose Cotransporter 2 Inhibitors Prevent Nephrolithiasis in Patients with Diabetes: A TriNetX-Based Real-World Global Comparison.

Chia-Min Liu, Daniel Hsiang-Te Tsai, Hsiu-Ting Tung, Ze-Hong Lu, Edward Chia-Cheng Lai, Chan-Jung Liu

Abstract readComparative StudyMulticenter Study
In one paragraph

Article in Kidney360, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chia-Min LiuDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-1722-3564
Daniel Hsiang-Te TsaiSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0003-2841-0338
Hsiu-Ting TungDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0009-0006-7668-9256
Ze-Hong LuDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-3605-2369
Edward Chia-Cheng LaiSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-5852-7652
Chan-Jung LiuDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-3929-286

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

key pointsSodium-glucose cotransporter 2 inhibitors (SGLT2is) were associated with lower nephrolithiasis risk compared with dipeptidyl peptidase-4 inhibitor and glucagon-like peptide-1 receptor agonist in patients with diabetes. Risk reduction with SGLT2i was consistent across age, glycemic control, body mass index, and renal function subgroups. Findings support potential use of SGLT2i as a preventive strategy for kidney stones in high-risk diabetic populations.

backgroundNephrolithiasis (NL) is a prevalent condition associated with diabetes mellitus (DM) and obesity, yet effective pharmacologic preventive options remain limited. Sodium-glucose cotransporter 2 inhibitors (SGLT2is), primarily used to manage type 2 DM, have shown potential lithoprotective effects.

methodsThis retrospective multinational cohort study used electronic health records from the TriNetX database. Adults with DM initiating SGLT2i, dipeptidyl peptidase-4 inhibitors (DPP4is), or glucagon-like peptide-1 receptor agonists (GLP-1RAs) were included. Propensity score matching was conducted to balance baseline covariates, yielding 358,096 matched pairs (SGLT2i versus DPP4i) and 371,374 pairs (SGLT2i versus GLP-1RA). The primary outcome was incidence of NL.

resultsSGLT2i use was associated with a significantly lower risk of NL compared with DPP4i (1.5% versus 1.9%; hazard ratio, 0.825; 95% confidence interval, 0.795 to 0.855; P < 0.001) and GLP-1RA (1.6% versus 2.0%; hazard ratio, 0.812; 95% confidence interval, 0.784 to 0.840; P < 0.001). Subgroup analyses showed consistent protective effects across age, hemoglobin A1c, body mass index, and renal function strata, although the association was slightly attenuated in older adults, those with suboptimal glycemic control, or impaired renal function.

conclusionsSGLT2is may reduce the risk of NL among patients with DM. Possible mechanisms include increased urinary citrate excretion, urinary alkalinization, and anti-inflammatory effects. These findings suggest that SGLT2i may reduce the risk of incident NL in diabetic populations, particularly those with additional metabolic risk factors for NL.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsNephrolithiasisSodium-Glucose Transporter 2 InhibitorsAdultAgedFemaleGlucagon-Like Peptide-1 Receptor AgonistsHumansMaleMiddle AgedRetrospective StudiesDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 Inhibitorskidney stonesSGLT2 inhibitors

Identifiers

PMID41117521
PMCPMC13065125

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.