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Risk Factors for Kidney Stone Development in GLP-1RA Users
Sofia Maurina Di Scipio, BA1, Shreya Thiagarajan, BS
2, Areeba Sadiq, MD
1.
1NYU Grossman Long Island, Mineola, NY, USA,
2University of Texas at Austin Dell Medical School, Austin, TX, USA.
BACKGROUND: Glucagon-like-peptide 1 receptor agonists (GLP-1RAs) are a class of diabetes mellitus (DM) medications that have emerged in popularity by enhancing glycemic control and promoting weight loss. Few studies have explored correlations between GLP-1RA use and kidney stone formation. This study identifies risk factors for stone development in GLP-1RA users.
METHODS: This retrospective study evaluated 258 patients, with and without kidney stones, started on Semaglutide, Liraglutide, or Dulaglutide between 2011 and 2023 from an IRB approved renal database. Stone developers were defined as patients who developed new stones or had stone growth on CT between 2018 and 2023 after starting GLP-1RAs. Chi square analyses on DM history, concurrent insulin use, race, sex, and insurance status were run in Microsoft Excel. Wilcoxon rank-sum and t-tests for hemoglobin A1c (HbA1c), serum creatinine (mg/dL), duration (mo), Charlson comorbidity index (CCI), age, and monthly weight loss (kg/mo) were run in R Version 4.4.1.
RESULTS: Increased duration of Semaglutide (p = 0.004), and higher CCI (p = 0.009) were correlated to stone development. History of DM (p = 0.025) and high serum creatinine (p = 0.025) were correlated with stone incidence in Semaglutide users. Concurrent insulin in DM patients was associated with stones in only Dulaglutide users (p = 0.029). Race, sex, age, insurance status, monthly weight loss, and HbA1c differences before and after medication did not differ significantly.
CONCLUSIONS:This study reveals associations between GLP-1RA administration and stone development risk that are mediated by comorbid DM and concurrent insulin use. These findings may guide patients and providers in selecting an appropriate GLP-1RA therapy for DM management while mitigating stone risk. Further research is warranted to confirm these associations, understand the mechanism, and determine if confounding factors affect increased stone risk.
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