Abstract: TH-PO0844
GLP-1 Receptor Agonist Use and Stone Recurrence in Uric Acid Nephrolithiasis
Session Information
- Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
- 1900 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
Authors
- Ruchi, Rupam, University of Florida, Gainesville, Florida, United States
- Bacudio, Lawrence, University of Florida, Gainesville, Florida, United States
- Bird, Vincent G., University of Florida, Gainesville, Florida, United States
Group or Team Name
- Multidisciplinary Nephrology-Urology Kidney Stone Group
Background
GLP1 receptor agonists (GLP1RA) are increasingly used for diabetes & obesity, two major risk factors for uric acid nephrolithiasis. However, their effect on stone recurrence remains unknown. We hypothesized that GLP1RA use would reduce recurrence among uric acid stone formers.
Methods
In this retrospective cohort study, we identified patients from a surgical database with >50% uric acid stone composition who were treated with GLP1RA for at least one year,and had been on stone prevention diet/supplement/medical therapy as indicated. Stone recurrence was defined by stone passage, imaging, or procedures. Baseline demographics and comorbidities were collected. Categorical variables were compared using chi-square testing. Multivariable logistic regression was performed with stone recurrence as the dependent variable and GLP1RA use, diabetes mellitus, gout, hyperuricemia, hypertension, and cardiovascular disease as covariates. Adjusted odds ratios with 95% confidence intervals were reported.
Results
94 patients were identified; 53 received GLP1RA therapy and 41 did not. Mean age was 60.8 ± 11.2 years, and 51.1% were male. Mean BMI was higher in the GLP1RA group (40.5 ± 10.3 vs 33.2 ± 9.1 kg/m2, p=0.001). Median follow-up duration was similar between groups (46.7 vs 39.6 months, p=0.64). Diabetes and hypertension were more prevalent in the GLP1RA group (77.4% and 77.4%) compared with the non-GLP1RA group (34.1% and 48.8%; p<0.001 and p=0.004, respectively). Among patients with paired HbA1c data, the GLP1RA group demonstrated a significant HbA1c reduction from 8.13 ± 1.50% to 7.24 ± 1.47% (p=0.0008); no significant change was observed in the non-GLP1RA group (p=0.85). Stone recurrence occurred in 71.6% of the GLP1RA group versus 68.2% of the non-GLP1RA group (p=0.72; OR 1.18, 95% CI 0.48–2.86). Multivariable logistic regression demonstrated no association between GLP1RA therapy and stone recurrence (adjusted OR 1.02, 95% CI 0.37–2.83, p=0.97). Among patients with paired urine pH data (n=6), mean urine pH increased from 5.52 ± 0.31 to 5.81 ± 0.81 after GLP1RA therapy.
Conclusion
GLP1RA use was associated with improved hemoglobin A1c and a trend toward increased urine pH but did not reduce stone recurrence among patients with uric acid nephrolithiasis. Further studies are needed to evaluate the effects of GLP1RA therapy on 24-hour urine parameters, particularly urine pH, citrate, uric acid excretion, and urine volume.