Effect of Dapagliflozin versus standard care on risk of recurrence of kidney stones measured by urinary super-saturation: A Randomised placebo controlled study

Nephrolithiasis is a common renal disease that frequently recurs and amounts to large disease burden in Indian patients with no effective evidence based preventive medication. A huge number of patients have to undergo different types of surgeries for stone clearance. Despite of getting cleared stone almost 50 percent patients land up with re-stone formation in next 10 years. Patients with multiple stones and / or abnormal urinary super-saturation have high risk of repeated stone formation. Surgical interventions are associated with morbidity, prolonged hospital stay, sepsis or death in few cases. If not managed timely may lead to renal failure. There is no definitive means to prevent or delay the recurrence of stone disease in urinary tract. Sodium-glucose cotransporter-2 (SGLT2, encoded by SLC5A2) inhibitors, a novel class of antidiabetic agents, induce urinary glucose excretion by inhibiting SGLT2 at the S1 and S2 segments of the proximal tubules. Apart from glycaemic control, SGLT2 inhibitors have diverse functions, including blood pressure reduction improved cardiovascular outcomes, renoprotection, lipid improvement, and weight, visceral fat, and serum uric acid level reduction.