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

<i>Background</i>: 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 underex...

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Main Authors: Mohammed Abdulrasak, Ali Someili, Mostafa Mohrag
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/61/5/921
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author Mohammed Abdulrasak
Ali Someili
Mostafa Mohrag
author_facet Mohammed Abdulrasak
Ali Someili
Mostafa Mohrag
author_sort Mohammed Abdulrasak
collection DOAJ
description <i>Background</i>: 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. <i>Methods</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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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spelling doaj-art-486335073daf4cb69f124c763ae544fd2025-08-20T02:33:58ZengMDPI AGMedicina1010-660X1648-91442025-05-0161592110.3390/medicina61050921SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical ConsiderationsMohammed Abdulrasak0Ali Someili1Mostafa Mohrag2Department of Clinical Sciences, Lund University, 22100 Malmo, SwedenDepartment of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi ArabiaDepartment of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia<i>Background</i>: 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. <i>Methods</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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.https://www.mdpi.com/1648-9144/61/5/921SGLT2 inhibitorsurogenital malformationsurinary tract infectionsurinary diversionsbenign prostatic hyperplasia
spellingShingle Mohammed Abdulrasak
Ali Someili
Mostafa Mohrag
SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations
Medicina
SGLT2 inhibitors
urogenital malformations
urinary tract infections
urinary diversions
benign prostatic hyperplasia
title SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations
title_full SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations
title_fullStr SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations
title_full_unstemmed SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations
title_short SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations
title_sort sglt2 inhibitors in patients with urogenital malformations and urinary diversions risks benefits and clinical considerations
topic SGLT2 inhibitors
urogenital malformations
urinary tract infections
urinary diversions
benign prostatic hyperplasia
url https://www.mdpi.com/1648-9144/61/5/921
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