Abstract: FR-PO0278
Effect of SGLT2 Inhibitor and GLP-1 Receptor Agonist Treatment on Urine and Plasma Parameters Involved in Lithogenesis in Patients with Diabetes
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Zaidan, Nadim, Northwell Health, New Hyde Park, New York, United States
- Araji, Hachem, Northwell Health, New Hyde Park, New York, United States
- Habib, Toni, Northwell Health, New Hyde Park, New York, United States
- Dankar, Razan, Northwell Health, New Hyde Park, New York, United States
- El-Charabaty, Elie, Northwell Health, New Hyde Park, New York, United States
- El Sayegh, Suzanne E., Northwell Health, New Hyde Park, New York, United States
Background
Diabetes mellitus (DM) is recognized as a risk factor for kidney stone disease (KSD). While some studies have started showing a beneficial role of antidiabetics (AD) like sodium glucose transporters type II inhibitors (SGLT2i) and glucagon like peptide 1 receptor agonists (GLP1Ra) in KSD prevention, the combined effect of these drugs on urinary chemistry and risk prevention has not yet been fully elucidated.
Methods
In this single-center retrospective chart review of ambulatory patients seen between 2018 and 2023 at Northwell SIUH, type II DM patients were screened. Those with urine and plasma samples collected on the same date were extracted and their demographic characteristics, clinical comorbidities, laboratory data and medication regimen recorded. This cohort was subdivided into 4 groups, based on SGLT2i and GLP1Ra use in addition to other AD, with the Kruskal Wallis test comparing plasma and urine parameters (Table). Multivariate Cox analysis for incident KSD events was also performed. All statistical analyses were performed using GraphPad Prism 10 with a p-value of 0.05 considered statistically significant.
Results
151 patients (91 male and 60 female) were included in the cohort, with a mean age of 62.6±11.6 y. Based on the type of AD, 22 patients were on SGLT2i, 28 on GLP1a, 17 on both and 84 on neither drug. Notably, patients on both agents tended to have the lowest urine pH across the 4 groups, while patients on GLP1Ra had significantly the lowest urine density, particularly compared to those on SGLT2i (1.022±0.007 vs 1.027±0.011, p = 0.02 on Kruskal Wallis). Incident KSD occurred in 8 patients and Cox regression adjusted for age, sex and metabolic parameters did not find incident KSD risk to be significantly influenced by AD regimen (HR = 1.081 [0.504 to 2.09]).
Conclusion
SGLT2i and GLP1Ra might impact urine and plasma metabolic parameters. Their modulating effect on lithogenesis metabolic factors should be investigated in larger samples.
Impact of antidiabetics on plasma and urine parameters
| Only SGLT2i | Only GLP1Ra | Both | Neither | p-value | ||
| Plasma | Na | 140±2.67 | 139±3.18 | 140±2.69 | 140±3.47 | 0.421 |
| HCO3- | 23.8±3.45 | 24.8±2.54 | 24.9±1.95 | 24.8±2.59 | 0.573 | |
| Ca | 9.66±0.457 | 9.59±0.440 | 9.58±0.728 | 9.46±0.411 | 0.157 | |
| Urine | pH | 6.39±0.655 | 6.05±0.438 | 6.03±0.374 | 6.13±0.572 | 0.219 |
| Specific Gravity | 1.027±0.011 | 1.022±0.007 | 1.025±0.008 | 1.023±0.026 | 0.024 |