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SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions : Risks, Benefits, and Clinical Considerations

Abdulrasak, Mohammed LU orcid ; Someili, Ali and Mohrag, Mostafa (2025) In Medicina (Kaunas, Lithuania) 61(5).
Abstract

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly used in patients with type 2 diabetes, chronic kidney disease, and heart failure. However, their safety and efficacy in patients with congenital or surgically altered urogenital anatomy remains underexplored. Methods: We conducted a narrative review of current evidence regarding the use of SGLT2i in patients with urinary tract malformations, urinary diversions, and functional voiding disorders. Key risks, clinical considerations, and management strategies were synthesized from the existing literature and case reports. Results: Patients with benign prostatic hyperplasia, vesicoureteral reflux, neurogenic bladder, nephrostomies, and ileal conduits may face... (More)

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly used in patients with type 2 diabetes, chronic kidney disease, and heart failure. However, their safety and efficacy in patients with congenital or surgically altered urogenital anatomy remains underexplored. Methods: We conducted a narrative review of current evidence regarding the use of SGLT2i in patients with urinary tract malformations, urinary diversions, and functional voiding disorders. Key risks, clinical considerations, and management strategies were synthesized from the existing literature and case reports. Results: Patients with benign prostatic hyperplasia, vesicoureteral reflux, neurogenic bladder, nephrostomies, and ileal conduits may face increased risks of urinary tract infections, fungal colonization, and therapy-related complications due to persistent glycosuria and altered urinary flow. Nevertheless, these patients may still benefit from SGLT2i's systemic renal and cardiovascular effects. Individualized risk assessment, close monitoring, and multidisciplinary management are essential. Conclusions: Patients with urological abnormalities represent a high-risk but potentially high-reward population for SGLT2i therapy. A cautious, tailored approach is necessary, and future dedicated research is urgently needed to better guide clinical practice.

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author
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organization
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type
Contribution to journal
publication status
published
subject
keywords
Humans, Sodium-Glucose Transporter 2 Inhibitors/therapeutic use, Diabetes Mellitus, Type 2/drug therapy, Urinary Diversion/methods, Urogenital Abnormalities/complications, Risk Assessment/methods, Male
in
Medicina (Kaunas, Lithuania)
volume
61
issue
5
article number
921
publisher
MDPI AG
external identifiers
  • pmid:40428879
ISSN
1648-9144
DOI
10.3390/medicina61050921
language
English
LU publication?
yes
id
5db6002b-5219-4080-8f91-4c4823bcc842
date added to LUP
2025-05-29 17:08:29
date last changed
2025-06-02 08:51:27
@article{5db6002b-5219-4080-8f91-4c4823bcc842,
  abstract     = {{<p>Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly used in patients with type 2 diabetes, chronic kidney disease, and heart failure. However, their safety and efficacy in patients with congenital or surgically altered urogenital anatomy remains underexplored. Methods: We conducted a narrative review of current evidence regarding the use of SGLT2i in patients with urinary tract malformations, urinary diversions, and functional voiding disorders. Key risks, clinical considerations, and management strategies were synthesized from the existing literature and case reports. Results: Patients with benign prostatic hyperplasia, vesicoureteral reflux, neurogenic bladder, nephrostomies, and ileal conduits may face increased risks of urinary tract infections, fungal colonization, and therapy-related complications due to persistent glycosuria and altered urinary flow. Nevertheless, these patients may still benefit from SGLT2i's systemic renal and cardiovascular effects. Individualized risk assessment, close monitoring, and multidisciplinary management are essential. Conclusions: Patients with urological abnormalities represent a high-risk but potentially high-reward population for SGLT2i therapy. A cautious, tailored approach is necessary, and future dedicated research is urgently needed to better guide clinical practice.</p>}},
  author       = {{Abdulrasak, Mohammed and Someili, Ali and Mohrag, Mostafa}},
  issn         = {{1648-9144}},
  keywords     = {{Humans; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use; Diabetes Mellitus, Type 2/drug therapy; Urinary Diversion/methods; Urogenital Abnormalities/complications; Risk Assessment/methods; Male}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  publisher    = {{MDPI AG}},
  series       = {{Medicina (Kaunas, Lithuania)}},
  title        = {{SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions : Risks, Benefits, and Clinical Considerations}},
  url          = {{http://dx.doi.org/10.3390/medicina61050921}},
  doi          = {{10.3390/medicina61050921}},
  volume       = {{61}},
  year         = {{2025}},
}