Investigating the association between the administration of SGLT-2 inhibitors and the risk of urinary tract infection; a systematic review and meta-analysis

IF 0.2 Q4 UROLOGY & NEPHROLOGY

Journal of Renal Injury Prevention Pub Date : 2024-01-29 DOI:10.34172/jrip.2024.32276

Ramin Haghighi, Nasim Zaman Samghabadi, Roya Raeisi Jaski, Sonia Razmjou, Alireza Habibzadeh, Ahmad Maleki Ahmadabadi, Babak Gholamine, Mahdi Behi, Zahra Tavassoli

{"title":"Investigating the association between the administration of SGLT-2 inhibitors and the risk of urinary tract infection; a systematic review and meta-analysis","authors":"Ramin Haghighi, Nasim Zaman Samghabadi, Roya Raeisi Jaski, Sonia Razmjou, Alireza Habibzadeh, Ahmad Maleki Ahmadabadi, Babak Gholamine, Mahdi Behi, Zahra Tavassoli","doi":"10.34172/jrip.2024.32276","DOIUrl":null,"url":null,"abstract":"Introduction: Sodium-glucose transporter 2 (SGLT-2) inhibitors induce glycosuria. Therefore, using a meta-analysis study, this study aimed to evaluate the correlation between SGLT2 inhibitor administration and urinary tract infection (UTI) risk. Materials and Methods: In this systematic review and meta-analysis, we conducted searches on Scopus, PubMed, Web of Science, Cochrane, and Google Scholar without time limitations up to October 16, 2023. Data were analyzed using STATA 14 software, and a significance level of P < 0.05 was considered. Results: The combination of 11 studies revealed that the use of SGLT2 inhibitors, when compared to glucagon-like peptide-1 (GLP-1) receptor agonists, reduced the risk of UTI (OR = 0.77; 95% CI: 0.62, 0.95) and when compared to insulin (OR = 0.74; 95% CI: 0.63, 0.87). However, the administration of SGLT2 inhibitors, when compared to dipeptidyl peptidase‐4 (DPP‐4) inhibitors (OR = 1.09; 95% CI: 0.90, 1.32), sulfonylureas (OR = 1.35; 95% CI: 0.88, 2.05), biguanide initiators (OR = 1.14; 95% CI: 1.05, 1.24), thiazolidinediones (OR = 1.19; 95% CI: 0.58, 2.44), and other antidiabetic drugs (OR = 1.20; 95% CI: 0.92, 1.57), did not increase the risk of UTI. The administration of dapagliflozin (OR = 1.51; 95% CI: 0.60, 3.81), canagliflozin (OR = 1.22; 95% CI: 0.47, 3.15), and empagliflozin (OR = 3.22; 95% CI: 2.97, 3.48) showed associations with UTI risk. Furthermore, the correlation between SGLT2 inhibitors use and UTI risk was observed in cohort studies (OR = 1.14; 95% CI: 0.98, 1.32), cross-sectional studies (OR = 0.86; 95% CI: 0.64, 1.14), in males (OR = 1; 95% CI: 0.72, 1.40), and females (OR = 1.17; 95% CI: 0.91, 1.52). Conclusion: Empagliflozin, in contrast to dapagliflozin and canagliflozin, increases the risk of UTI. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (CRD42023479548) and Research Registry (UIN: reviewregistry1742) Websites","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Renal Injury Prevention","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34172/jrip.2024.32276","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Sodium-glucose transporter 2 (SGLT-2) inhibitors induce glycosuria. Therefore, using a meta-analysis study, this study aimed to evaluate the correlation between SGLT2 inhibitor administration and urinary tract infection (UTI) risk. Materials and Methods: In this systematic review and meta-analysis, we conducted searches on Scopus, PubMed, Web of Science, Cochrane, and Google Scholar without time limitations up to October 16, 2023. Data were analyzed using STATA 14 software, and a significance level of P < 0.05 was considered. Results: The combination of 11 studies revealed that the use of SGLT2 inhibitors, when compared to glucagon-like peptide-1 (GLP-1) receptor agonists, reduced the risk of UTI (OR = 0.77; 95% CI: 0.62, 0.95) and when compared to insulin (OR = 0.74; 95% CI: 0.63, 0.87). However, the administration of SGLT2 inhibitors, when compared to dipeptidyl peptidase‐4 (DPP‐4) inhibitors (OR = 1.09; 95% CI: 0.90, 1.32), sulfonylureas (OR = 1.35; 95% CI: 0.88, 2.05), biguanide initiators (OR = 1.14; 95% CI: 1.05, 1.24), thiazolidinediones (OR = 1.19; 95% CI: 0.58, 2.44), and other antidiabetic drugs (OR = 1.20; 95% CI: 0.92, 1.57), did not increase the risk of UTI. The administration of dapagliflozin (OR = 1.51; 95% CI: 0.60, 3.81), canagliflozin (OR = 1.22; 95% CI: 0.47, 3.15), and empagliflozin (OR = 3.22; 95% CI: 2.97, 3.48) showed associations with UTI risk. Furthermore, the correlation between SGLT2 inhibitors use and UTI risk was observed in cohort studies (OR = 1.14; 95% CI: 0.98, 1.32), cross-sectional studies (OR = 0.86; 95% CI: 0.64, 1.14), in males (OR = 1; 95% CI: 0.72, 1.40), and females (OR = 1.17; 95% CI: 0.91, 1.52). Conclusion: Empagliflozin, in contrast to dapagliflozin and canagliflozin, increases the risk of UTI. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (CRD42023479548) and Research Registry (UIN: reviewregistry1742) Websites

查看原文本刊更多论文

调查服用 SGLT-2 抑制剂与尿路感染风险之间的关联；系统综述和荟萃分析

简介钠-葡萄糖转运体 2（SGLT-2）抑制剂会诱发糖尿。因此，本研究采用荟萃分析法，旨在评估服用 SGLT2 抑制剂与尿路感染（UTI）风险之间的相关性。材料与方法：在本系统综述和荟萃分析中，我们在Scopus、PubMed、Web of Science、Cochrane和Google Scholar上进行了检索，检索时间不受限制，截至2023年10月16日。数据使用 STATA 14 软件进行分析，显著性水平为 P <0.05。结果综合 11 项研究发现，与胰高血糖素样肽-1 (GLP-1) 受体激动剂相比，使用 SGLT2 抑制剂可降低 UTI 风险（OR = 0.77；95% CI：0.62, 0.95），与胰岛素相比（OR = 0.74；95% CI：0.63, 0.87）也是如此。然而，与二肽基肽酶-4（DPP-4）抑制剂（OR = 1.09；95% CI：0.90，1.32）、磺脲类药物（OR = 1.35；95% CI：0.88，2.05）、双胍类起始剂（OR = 1.14；95% CI：1.05，1.24）、噻唑烷二酮类（OR = 1.19；95% CI：0.58，2.44）和其他抗糖尿病药物（OR = 1.20；95% CI：0.92，1.57）不会增加 UTI 风险。服用达帕格列净（OR = 1.51；95% CI：0.60，3.81）、卡那格列净（OR = 1.22；95% CI：0.47，3.15）和恩帕格列净（OR = 3.22；95% CI：2.97，3.48）与 UTI 风险有关。此外，在队列研究（OR = 1.14；95% CI：0.98，1.32）、横断面研究（OR = 0.86；95% CI：0.64，1.14）、男性（OR = 1；95% CI：0.72，1.40）和女性（OR = 1.17；95% CI：0.91，1.52）中均观察到使用 SGLT2 抑制剂与 UTI 风险之间的相关性。结论与达帕格列净和卡格列净相比，恩帕格列净会增加UTI风险。注册：本研究根据PRISMA核对表编制，其研究方案已在PROSPERO（CRD42023479548）和研究注册中心（UIN：reviewregistry1742）网站注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.