SGLT2i in Kidney Stones
SGLT2i in Calcium Kidney Stones
This study is looking at whether empagliflozin, a medication typically used for diabetes and heart conditions, may affect factors that contribute to kidney stone formation. The research focuses on people who have had calcium-based kidney stones, i.e. calcium oxalate or calcium phosphate stones.
Previous studies in those without kidney stones found that empagliflozin increased urinary citrate levels without raising urine pH. The investigators are testing whether similar effects occur in people with a history of kidney stones.
Participants will take empagliflozin daily for 4 weeks. The investigators will collect 24-hour urine samples before and after treatment to measure various factors that influence stone formation, including citrate levels, pH, and calculated stone formation risk. The investigators will enroll 32 participants: 16 with a history of calcium oxalate stones and 16 with calcium phosphate stones.
Results from this study may inform future larger clinical trials investigating empagliflozin as a kidney stone prevention strategy.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a single-center, prospective pilot study designed to evaluate the effects of the sodium-glucose co-transporter 2 inhibitor (SGLT2i), empagliflozin, on urinary risk factors in individuals with recurrent idiopathic calcium phosphate (CaP) or calcium oxalate (CaOx) kidney stones. Although empagliflozin is FDA-approved for other indications, it is being used off-label in our study to explore its potential for kidney stone prevention. The investigators' goal is to assess changes in urinary parameters relevant to stone formation, including citrate excretion, pH, and other metabolic markers.
Eligible participants will be adults aged 18 to 70 years with a documented history of CaP or CaOx kidney stones. Participants will be asked to stop certain medications and supplements prior to and during the study period if deemed safe by their primary care provider or nephrologist.
Each participant will complete two in-person study visits at the University of Chicago Clinical Research Center (CRC), a special research clinic, over approximately 4 weeks. They will also collect two 24-hour urine samples-one before starting the study drug and one at the end of the study. In addition, participants will take empagliflozin 10 mg once daily during the 4-week period and complete a brief phone or video check-in around the 2-week mark.
Laboratory tests and physical measurements will be performed during each visit. All urine samples will be analyzed by a central clinical laboratory (Litholink), and select samples will be stored for future analysis. Participants will be compensated for completing the study.
This pilot study is not intended to support a new drug indication or FDA labeling change. The findings will inform the design of a larger, hypothesis-driven study on the use of SGLT2 inhibitors in kidney stone prevention.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Early Phase 1
Contacts and Locations
Study Locations
-
-
Illinois
-
Chicago, Illinois, United States, 60637
- Recruiting
- University of Chicago
-
Contact:
- Megan Prochaska, MD
- Phone Number: 45488 (773) 702-1000
- Email: mprocha2@medicine.bsd.uchicago.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Calcium phosphate (CaP) stone participants:
- Age 18-70
History of at least one calcium phosphate (hydroxyapatite) stone
- Defined as at least 50% of stone material on most recent stone analysis
Calcium oxalate (CaOx) stone participants:
- Age 18-70
History of at least one calcium oxalate stone
- Defined as at least 50% of stone material on most recent stone analysis.
Other inclusion criteria considerations: The investigators will study balanced numbers of male and females. Prior studies did not have balanced representation of male and female sexes. In prior studies, less than 40% were female, or sex data is not presented. Study of both male and female sex is crucial with kidney stones and therapies that affect citrate and pH because there are well established epidemiologic differences in stone type and physiologic differences in acid-base handling by sex. Epidemiologically, younger women are more likely to have CaP stones, and this is likely because they have higher urine pH.
Exclusion Criteria:
- History of primarily brushite, uric acid, cysteine, or struvite stones
- History of severe acid-base abnormality, very low (less than 100mg/day) or very high (greater than 1500mg/day) urine citrate
- Participants who cannot stop diuretic medication or alkali supplementation for the course of the study period
- Use of drugs that can directly affect proximal tubule function (e.g., topiramate)
- Diagnosis of complete distal renal tubular acidosis
- Diagnosis of chronic kidney disease (eGFR <60 mL/min/1.73m²)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: CaP (Calcium Phosphate) stone patients
Defined as >50% calcium phosphate content on most recent stone analysis Age 18-70 years
|
Empagliflozin (Jardiance®), 10 mg tablet taken orally once daily for 4 weeks.
Dispensed at baseline by the Investigational Drug Service.
It will be administered at home by participants.
|
|
Active Comparator: CaOx (Calcium Oxalate) stone patients
Defined as >50% calcium oxalate content on most recent stone analysis Age 18-70 years
|
Empagliflozin (Jardiance®), 10 mg tablet taken orally once daily for 4 weeks.
Dispensed at baseline by the Investigational Drug Service.
It will be administered at home by participants.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in calcium phosphate
Time Frame: 4 weeks
|
Calcium phosphate supersaturation will be measured or calculated at baseline and study completion.
The investigators will calculate change in calcium phosphate supersaturation for all participants and within each group.
|
4 weeks
|
|
Change in urine citrate
Time Frame: 4 weeks
|
Urine citrate will be measured or calculated at baseline and study completion.
The investigators will calculate change in urine citrate for all participants and within each group.
|
4 weeks
|
|
Change in pH
Time Frame: 4 weeks
|
pH will be measured or calculated at baseline and study completion.
The investigators will calculate change in pH for all participants and within each group.
|
4 weeks
|
|
Calcium oxalate supersaturation
Time Frame: 4 weeks
|
Calcium oxalate supersaturation will be measured or calculated at baseline and study completion.
The investigators will calculate change in calcium oxalate supersaturation for all participants and within each group.
|
4 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in 24-hour urine citrate excretion (mg/day) from baseline to 4 weeks
Time Frame: 4 weeks
|
24-hour urine citrate excretion will be measured at baseline and study completion.
The change from baseline to 4 weeks will be calculated for each participant and compared between CaP and CaOx stone groups.
|
4 weeks
|
|
Change in urine pH from baseline to 4 weeks
Time Frame: 4 weeks
|
Urine pH will be measured at baseline and study completion.
The change from baseline to 4 weeks will be calculated for each participant and compared between groups.
|
4 weeks
|
|
Change in calcium phosphate supersaturation from baseline to 4 weeks
Time Frame: 4 weeks
|
Calcium phosphate supersaturation will be calculated using EQUIL2 at baseline and 4 weeks.
The change will be calculated for each participant and compared between groups.
|
4 weeks
|
|
Change in calcium oxalate supersaturation from baseline to 4 weeks
Time Frame: 4 weeks
|
Calcium oxalate supersaturation will be calculated using EQUIL2 at baseline and 4 weeks.
The change will be calculated for each participant and compared between groups.
|
4 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Male Urogenital Diseases
- Calculi
- Pathological Conditions, Anatomical
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urolithiasis
- Urinary Calculi
- Nephrolithiasis
- Pathological Conditions, Signs and Symptoms
- Kidney Calculi
- Sodium-Glucose Transporter 2 Inhibitors
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Hypoglycemic Agents
- empagliflozin
Other Study ID Numbers
Other Study ID Numbers
- IRB25-0673
- 1R01DK144310 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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