Urinary dipstick findings and UTI risk with SGLT2 inhibitors: a post-hoc analysis of the CANVAS and CREDENCE trials.
Nephrol Dial TransplantSep 30, 2026
Yohei Doi, Takayuki Hamano, Mayumi Fukuda-Doi et al.
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In 30 seconds
This post-hoc analysis of the CANVAS and CREDENCE trials evaluated the relationship between urinary dipstick findings and UTI risk in 8614 participants with type 2 diabetes. The study found that while abnormal leukocyte esterase (LE) and nitrite levels were associated with increased UTI risk, canagliflozin did not significantly elevate this risk, with a hazard ratio of 1.07 for first UTIs.
Key findings
- 10.7% of participants had abnormal LE, and 3.5% had abnormal nitrite.
- The risk of first UTI increased with greater LE positivity: HR 1.72, 1.92, 2.81 for 1+, 2+, 3+ vs normal.
- Canagliflozin did not increase the risk of first UTI (HR 1.07; 95% CI 0.93-1.22).
- For total UTI events, canagliflozin's HR was 1.01 (95% CI 0.86-1.17).
Why it matters
Understanding the relationship between urinary dipstick findings and UTI risk is crucial for clinicians prescribing SGLT2 inhibitors, as concerns about UTI may influence treatment decisions in high-risk patients.