SGLT-2 inhibitors for the prevention of recurrent nephrolithiasis

New study reports protective effect among people with type 2 diabetes Kidney stones and the systemic conditions associated with them have a major impact on health and the economy in the US and worldwide.12 In recent years, the prevalence of kidney stones has increased in parallel with the epidemics of obesity and metabolic syndrome, as well as cardiorenal disease. Since 1988, when the US Food and Drug Administration approved potassium citrate to prevent recurrent nephrolithiasis, no other drug has been introduced for the secondary prevention of this chronic illness. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are an accepted treatment for type 2 diabetes and have also emerged as a novel therapeutic class with beneficial cardiorenal effects.3 In a linked paper, McCormick and colleagues (doi:10.1136/bmj-2024-080035) report a target trial emulation study evaluating SGLT-2 inhibitors in adults with recurrent nephrolithiasis and type 2 diabetes using the general Canadian population database.4 After inverse probability weighting or propensity score overlap weighting to balance the study groups, the authors compared treatment with SGLT-2 inhibitors versus competitor agents, including glucagon-like peptide-1 (GLP-1) receptor …