There is a need for innovative pharmaceutical intervention in light of the increasing prevalence of metabolic disease and cardiovascular disease. The kidneys’ sodium-glucose cotransporter 2 inhibitors (SGLT2) receptors are targeted to reduce glucose reabsorption by SGLT2. Patients with type 2 diabetes mellitus (T2DM) benefit the most from reduced blood glucose levels, although this is just one of the numerous physiological consequences. To establish existing understanding and possible advantages and risks for SGLT2 inhibitors in clinical practice, this article will explore the influence of SGLT2 inhibitors on six major organ systems. In addition, this literature review will discuss the benefits and potential drawbacks of SGLT2 inhibitors on various organ systems and their potential application in therapeutic settings.

Background and Clinical Significance: Renal abscess represents one infectious urological complication with lethal potential. The treatment of this pathology may differ depending on the severity of the symptoms and the size of the infectious collection. Diabetes, immunosuppression, and associated urinary pathologies are most frequently responsible for the development of abscesses. This case report presents the first documented case of a renal abscess associated with Sodium-glucose cotransporter 2 (SGLT2) inhibitors in a person without previous predisposing pathologies. Case Presentation: A 62-year-old patient presented to the emergency department for pain in the right flank, vomiting, and dysuria. The patient’s medical history revealed Heart Failure New York Heart Association (NYHA) Class II, Coronary Artery Disease (CAD) with prior angioplasty, and permanent Atrial Fibrillation. No prior urological or immunosuppressive conditions were detected. The Computed Tomography (CT) evaluation confirmed the ultrasound suspicion of a right renal abscess performed in the emergency room. The only risk factor identified was the initiation of SGLT2 inhibitor therapy for cardiac pathology approximately 2 months before. According to the small dimensions and urine culture, the abscess was successfully treated with antibiotic administration in collaboration with the urology department. The infectious process was remitted within 2 weeks. Conclusions: To our knowledge this is the first documented case of a renal abscess associated with SGLT2 inhibitor administration in a person without previous predisposing risk factors. Despite the relatively low incidence of urinary tract infections (UTIs) associated with SGLT2 inhibitors, their widespread use in the treatment of various socially significant conditions highlights the need for both patients and medical specialists to be aware of all potential risks and pay increased attention to these cases.

Background and Clinical Significance: Sodium–glucose cotransporter-2 (SGLT2) inhibitors cause persistent glucosuria, which has been hypothesized to facilitate urinary tract infection (UTI) when urinary stasis or anatomic variants coexist; causality, however, remains unproven and almost certainly multifactorial. Case Presentation: A 72-year-old man treated with dapagliflozin 10 mg/day for 4 months presented with 3 days of dysuria and nocturia, without fever or systemic signs. One month before SGLT2 inhibitor initiation, urological work-up had been unremarkable: prostate ~50 cm³, post-void residual (PVR) 0 mL, and a negative midstream culture. At presentation we obtained a midstream clean-catch specimen before antibiotics. Dipstick showed glucose 2+ (~100 mg/dL, as expected with SGLT2 inhibition), leukocyte esterase 3+ and nitrites negative; microscopy revealed 45 leukocytes/high-power field with pronounced bacteriuria. Quantitative culture grew Morganella morganii at 1 × 10⁵ CFU/mL in pure culture. Antimicrobial susceptibility (VITEK^® 2 Compact, EUCAST v14.0, 2024) demonstrated resistance to ampicillin, amoxicillin–clavulanate, ampicillin–sulbactam, ceftriaxone, ceftazidime, gentamicin and trimethoprim–sulfamethoxazole, with susceptibility (S) retained only to piperacillin–tazobactam, levofloxacin/norfloxacin, cefepime and carbapenems (ertapenem, meropenem). Imaging revealed a right duplicated ureter with distal fusion (single bladder insertion, no dilatation or obstruction) and benign prostatic hyperplasia with PVR ~100 mL; renal function was preserved, two blood culture sets (pre-antibiotic) were negative, and repeat urine culture on day 7 was sterile. Management/outcome: The episode was classified as a localized (cystitis-range) UTI per European Association of Urology (EAU) criteria (no fever, flank pain or bacteremia). Meropenem 1 g intravenously every 8 h (3 g/day) was given for 10 days after urology/infectious-disease review. Dapagliflozin was held at presentation and not restarted during the 3-month follow-up period; reintroduction was planned only after full urological reassessment with cardiology input. Transurethral resection of the prostate (TUR-P) was performed 18 days after completing antibiotics (28 days after presentation) for bladder outlet obstruction refractory to tamsulosin 0.4 mg daily, with complete resolution of symptoms, normalization of inflammatory markers and PVR 0 mL. No recurrence occurred during 3 months of follow-up after TUR-P. Conclusions: This single case illustrates a temporal association—not proven causation—between SGLT2-related glucosuria, incomplete emptying and a non-obstructive duplicated ureter that likely created a permissive milieu for opportunistic Morganella UTI. The narrative is hypothesis-generating; urinary stasis was the dominant modifiable factor. Culture-guided therapy, individualized decisions on SGLT2 continuation, and definitive correction of outlet obstruction are the practical takeaways.

Background: Glucagon-like peptide-1 receptor agonists and dual GIP/GLP-1 receptor agonists produce substantial weight loss and improve glycemic control, but their relationship with urinary stone recurrence remains incompletely characterized. We evaluated clinically and radiologically confirmed recurrent stone episodes occurring after initiation of semaglutide or tirzepatide. Methods: This retrospective single-center cohort screened 168 adults receiving semaglutide or tirzepatide. Four patients with previous bariatric surgery, 33 without at least 6 months of post-initiation clinical follow-up, and five with hyperparathyroidism were excluded, leaving 126 participants. Follow-up was calculated from GLP-1-based therapy initiation to the last documented clinical or imaging assessment. Recurrence required a stone episode documented before treatment initiation and a new symptomatic or radiologically progressive stone event after initiation. Results: The cohort included 94 semaglutide and 32 tirzepatide users. Median follow-up was 9 months [IQR 8–12]. Thirteen patients (10.3%; 95% CI 6.1–16.9%) had a recurrent episode after treatment initiation. No measured demographic, metabolic, renal, hydration-related, electrolyte, or treatment characteristic clearly differentiated patients with and without recurrence. Allopurinol use was more frequent among recurrent stone formers in an unadjusted analysis, a finding considered exploratory and likely affected by confounding by indication. Conclusions: In this single-arm cohort, 10.3% of patients had clinically and radiologically documented stone recurrence after GLP-1-based therapy initiation. The study describes post-initiation events but cannot estimate treatment-attributable risk because it lacked an untreated comparator, pre-treatment incidence-rate analysis, standardized surveillance, and complete exposure data. Larger prospective comparator studies with baseline imaging, time-to-event follow-up, complete urinary chemistry, and treatment-dose data are required.

Background: Sodium–glucose cotransporter 2 inhibitors are guideline-directed therapy for heart failure with preserved ejection fraction (HFpEF), but comparative genitourinary safety data for dapagliflozin and empagliflozin in HFpEF-treated populations remain limited. Objective: To compare 6-month symptomatic urinary tract infection (UTI), asymptomatic bacteriuria, and other genitourinary adverse events among patients newly initiated on dapagliflozin or empagliflozin for HFpEF. Methods: This retrospective, single-centre comparative cohort study included 239 adults with physician-documented HFpEF retained after a requirement for at least 6 months of continuous follow-up: 113 received dapagliflozin 10 mg once daily and 126 received empagliflozin 10 mg once daily. The original outcome of any documented bacteriuria/UTI was separated into symptomatic UTI and asymptomatic bacteriuria. Risk differences and 95% confidence intervals were calculated; a multivariable logistic model of the original documented bacteriuria/UTI composite adjusted for age, sex, and baseline estimated glomerular filtration rate (eGFR). Results: Any documented bacteriuria/UTI occurred in 21/113 (18.6%) dapagliflozin-treated participants and 25/126 (19.8%) empagliflozin-treated participants. Symptomatic UTI occurred in 4/113 (3.5%) and 5/126 (4.0%), respectively; 17/113 (15.0%) and 20/126 (15.9%) had documented asymptomatic bacteriuria. The risk difference for the composite, calculated as empagliflozin minus dapagliflozin, was 1.3 percentage points (95% CI −8.9 to 11.2). The adjusted odds ratio was 1.62 (95% CI 0.76–3.45; p = 0.208). Other genitourinary events were uncommon and estimates were imprecise. Conclusions: No statistically detectable between-group difference was found in symptomatic UTI, asymptomatic bacteriuria, or the original composite outcome. Confidence intervals were wide and compatible with clinically meaningful differences in either direction. These exploratory findings require confirmation in prospective multicentre studies with standardized culture ascertainment and complete follow-up.

Introduction: Cardiac remodeling is a relevant and unfavorable evolution of myocardial infarction, which is associated with an increased risk of progression to overt heart failure (HF). It is currently acknowledged as a fundamental therapeutic objective that clinicians must address from the acute event to the comprehensive clinical follow-up. Aim: The aim of the study was to assess the importance of left ventricular hypertrophy (LVH) in acute myocardial infarction (AMI) extension. Patients, Materials and Methods: Inclusion criteria: anterior V1–V4 ST-segment elevation myocardial infarction (STEMI) and left ventricular ejection fraction (LVEF) >50%. Exclusion criteria: other STEMI locations, heart disorders, systemic diseases. Patients underwent pharmacological or percutaneous revascularization. Echocardiography was performed until day 3 of AMI and after 14 days. To measure the length of the expansion segment (LES), an original mathematical formula was obtained using the parasternal short-axis view at the papillary muscle level, myocardial mass (MM), and interventricular septum thickness (IST). Statistical studies have used the Student’s t-test, the linear regression equations and the Pearson’s correlation coefficient. Results: 172 AMI patients were analyzed and divided into two groups. Patients with LVH showed a strong reverse Pearson’s correlation coefficient between LES and IST. For group II, a significant strongly reverse correlation for the LES and IST. Conclusions: Pre-existing LVH in AMI is associated with the limitation of the expansion. In the group without LVH, a 1 cm increase in LES corresponds to a 0.0622 cm decrease in IST.