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Asymptomatic pyuria and bacteriuria are not risk factors for urinary tract infection in women with type 2 diabetes mellitus initiated SGLT2 inhibitors

  • Nephrology - Original Paper
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Abstract

Purpose

Asymptomatic pyuria and bacteriuria are more prevalent in diabetic patients and may be associated with urinary tract infection (UTI). The aim of this study is to investigate the association between asymptomatic pyuria/bacteriuria at the initiation of SGLT2 inhibitor and UTI risk in female patients with type 2 diabetes.

Methods

The study was designed as a practical, single-center, prospective, cohort study. The female outpatients with type 2 diabetes initiated SGLT2 inhibitor were included. Patients who were symptomatic or treated in the past 3 months for urinary or genital tract infection, had a high risk for UTI were excluded. Hospitalization/antibiotic use for indications other than UTI were exclusion criteria during follow-up. All patients were followed up for 3 months. Pyuria and bacteriuria were exposure and, UTI was the outcome. Cumulative incidence and relative risk of UTI were analyzed for pyuria and bacteriuria.

Results

143 female patients were included among 1132 female type 2 diabetic patients. 13 patients were excluded during follow-up. 41.5% of the patients (n = 54) had pyuria and 28.5% (n = 37) had bacteriuria. The cumulative incidence of UTI was 20% in the whole cohort, 25,9% (n = 14/54) in the pyuria group and 18.9% (n = 7/37) in the bacteriuria group. The relative risk of UTI was 1.64 (95% CI: 0.82–3.26, p = 0.15) for pyuria, 0.92 (95% CI: 0.42–2.01, p = 0.84) for bacteriuria, and 1.2 (95% CI: 0.47–3.08, p = 0.69) for pyuria plus bacteriuria. Adjusted odd ratios revealed similar results.

Conclusions

Asymptomatic pyuria/bacteriuria at the initiation of SGLT2 inhibitors are not risk factors for UTI in women with type 2 diabetes.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Internal Medicine, Trabzon Araklı Public Hospital, Trabzon, Turkey

    Erman Akkuş

  2. Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey

    Erman Akkuş

  3. Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey

    Asena Gökçay Canpolat, Özgür Demir, Demet Çorapçıoğlu & Mustafa Şahin

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  1. Erman Akkuş
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  2. Asena Gökçay Canpolat
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  3. Özgür Demir
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  4. Demet Çorapçıoğlu
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  5. Mustafa Şahin
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Contributions

EA, AGC, ÖD, DÇ and MŞ designed the study. EA, and AGC collected the data. EA and MŞ performed the analyses. EA, AGC, ÖD, DÇ and MŞ interpreted the data. EA wrote the manuscript, EA, AGC, ÖD, DÇ and MŞ reviewed and made final approval of the manuscript. The corresponding author EA had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Erman Akkuş.

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Conflict of interests

The authors declare no conflicts of interest and competing financial interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the SBU Kanuni Education and Research Hospital, (Decision number: 2022/42).

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Akkuş, E., Gökçay Canpolat, A., Demir, Ö. et al. Asymptomatic pyuria and bacteriuria are not risk factors for urinary tract infection in women with type 2 diabetes mellitus initiated SGLT2 inhibitors. Int Urol Nephrol 56, 1165–1172 (2024). https://doi.org/10.1007/s11255-023-03798-5

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  • DOI: https://doi.org/10.1007/s11255-023-03798-5

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