La influencia de los inhibidores de SGLT2 en el riesgo de infección del tracto urinario en pacientes con Diabetes Mellitus tipo 2: una revisión integrativa de la literatura
DOI:
https://doi.org/10.15343/0104-7809.202549e17482025IPalabras clave:
Inhibidores del SGLT2, Infección del Tracto Urinario, Diabetes Mellitus Tipo 2Resumen
El objetivo de este estudio fue recopilar información sobre la influencia de los Inhibidores del Cotransportador de Sodio-Glucosa 2 (SGLT2i) en el riesgo de desarrollar infección del tracto urinario en pacientes con Diabetes Mellitus tipo 2. Se trata de una Revisión Integrativa de la Literatura (RIL), que recopiló datos de las siguientes bases: Biblioteca Virtual en Salud (BVS) y National Library of Medicine (PubMED). Los criterios de inclusión fueron: artículos publicados entre 2020 y 2024; en idiomas inglés, portugués y español; gratuitos y textos completos. Se excluyeron: artículos fuera del alcance de la temática abordada, duplicados, de pago y monografías. Se identificaron 73 artículos, de los cuales, tras la selección y el análisis realizados con el Software Zotero, quedaron 10 artículos. Los estudios incluidos señalaron una asociación entre el uso de SGLT2i y un mayor riesgo de ITU e infecciones urogenitales, principalmente con dapagliflozina, remogliflozina y glucosuria. Factores como un índice de masa corporal elevado y el sexo femenino presentan un papel más relevante en la predisposición a las ITU que el uso aislado de estos fármacos. A pesar de las divergencias, los beneficios de los SGLT2i superan los riesgos potenciales y, por ello, su uso sigue siendo recomendado, siempre que haya una supervisión profesional adecuada.
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A influência dos inibidores de SGLT2 no risco de infecção do trato urinário em pacientes com Diabetes Mellitus tipo 2: uma revisão integrativa da literatura
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Yang X, Chen H, Zheng Y, Qu S, Wang H, Yi F. Disease burden and long-term trends of urinary tract infections: A worldwide report. Front Public Health. 27 de julho de 2022;10:888205.
Kaur R, Kaur R. Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgraduate Medical Journal. 1o de dezembro de 2021;97(1154):803–12.
Timm MR, Russell SK, Hultgren SJ. Urinary tract infections: pathogenesis, host susceptibility and emerging therapeutics. Nat Rev Microbiol. fevereiro de 2025;23(2):72–86.
Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. The American Journal of Medicine. julho de 2002;113(1):5–13.
Jia H, Su W, Zhang J, Wei Z, Tsikwa P, Wang Y. Risk factors for urinary tract infection in elderly patients with type 2 diabetes: A protocol for systematic review and meta-analysis. Kokori E, organizador. PLoS ONE. 26 de setembro de 2024;19(9):e0310903.
Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global trends in diabetes complications: a review of current evidence. Diabetologia. janeiro de 2019;62(1):3–16.
Salari N, Karami MM, Bokaee S, Chaleshgar M, Shohaimi S, Akbari H, et al. The prevalence of urinary tract infections in type 2 diabetic patients: a systematic review and meta-analysis. Eur J Med Res. 5 de fevereiro de 2022;27(1):20.
Nunes CP, Giusti CT. EFICÁCIA E EVENTOS ADVERSOS DOS INIBIDORES DE SGLT2. Revista da Faculdade de Medicina de Teresópolis. 15 de dezembro de 2020; 4(1):14-21.
Hsu TL, Liu FH, Sun JH, Lin YH, Tsai CY, Lin CH. Cardiovascular Outcomes of Patients With Type 2 Diabetes With Urinary Tract Infection Post Sodium-Glucose Cotransporter 2 Inhibitors Treatment: A Multicenter Observational Study. Endocrine Practice. maio de 2025;31(5):592–8.
De Sousa MNA, Bezerra ALD, Do Egypto IAS. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. OLEL. 24 de outubro de 2023;21(10):18448–83.
Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. 3a ed. Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins; 2011.
Li CX, Liu LY, Zhang CX, Geng XH, Gu SM, Wang YQ, et al. Comparative safety of different sodium-glucose transporter 2 inhibitors in patients with type 2 diabetes: a systematic review and network meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne). setembro de 2023;14:1238399– 1238399.
Danysh HE, Johannes CB, Beachler DC, Layton JB, Ziemiecki R, Arana A, et al. Post-Authorization Safety Studies of Acute Liver Injury and Severe Complications of Urinary Tract Infection in Patients with Type 2 Diabetes Exposed to Dapagliflozin in a Real-World Setting. Drug Saf. 2023;46(2):175–93.
P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra State, India, Ferwani P, Maldar A, Shah N, Shah P, Chadha M. Prevalence of Bacterial Urinary Tract Infection Among Patients With Type 2 Diabetes Mellitus on Sodium-Glucose Cotransporter-2 Inhibitors: A Prospective Real-World Setting Study. JAFES. 25 de novembro de 2022;37(2):5–8.
Alkabbani W, Zongo A, Minhas-Sandhu JK, Eurich DT, Shah BR, Alsabbagh MW, et al. Sodium-Glucose Cotransporter-2 Inhibitors and Urinary Tract Infections: A Propensity Score–matched Population-based Cohort Study. Canadian Journal of Diabetes. junho de 2022;46(4):392-403.e13.
Iordan L, Avram VF, Timar B, Sturza A, Popescu S, Albai O, et al. Safety of SGLT2 Inhibitors and Urinary Tract Infections in Clinical Practice-A Cross-Sectional Study. Medicina (Kaunas). 1o de dezembro de 2024;60(12):1974.
Mashraqi MM, Chaturvedi N, Alam Q, Alshamrani S, Bahnass MM, Ahmad K, et al. Biocomputational Prediction Approach Targeting FimH by Natural SGLT2 Inhibitors: A Possible Way to Overcome the Uropathogenic Effect of SGLT2 Inhibitor Drugs. Molecules. 22 de janeiro de 2021;26(3):582.
Ueda M, Zenibayashi M, Yamada T, Asahara SI, Ogawa W. Comparison over Time of Adverse Drug Reactions in Diabetes Patients Treated with Sodium-Glucose Cotransporter 2 Inhibitors. Kobe J Med Sci. agosto de 2024;70(3):E81–8.
Chen L, Xue Q, Yan C, Tang B, Wang L, Zhang B, et al. Comparative safety of different recommended doses of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis of randomized clinical trials. Front Endocrinol (Lausanne). novembro de 2023;14:1256548–1256548.
Tanriverdi M, Bastemir M, Demirbakan H, Ünalan A, Türkmen M, Tanriverdi GÖ. Association of SGLT-2 inhibitors with bacterial urinary tract infection in type 2 diabetes. BMC Endocr Disord. outubro de 2023;23(1):211–211.
Lin DSH, Lee JK, Chen WJ. Clinical Adverse Events Associated with Sodium-Glucose Cotransporter 2 Inhibitors: A Meta-Analysis Involving 10 Randomized Clinical Trials and 71 553 Individuals. J Clin Endocrinol Metab. 2021;106(7):2133–45.
Benjamin T, Schumacher C. Characterization of Risk Factors for Genitourinary Infections with Sodium‐Glucose Cotransporter‐2 Inhibitors. Pharmacotherapy. outubro de 2020;40(10):1002–11.
Anan G, Kikuchi D, Omae K, Hirose T, Okada K, Mori T. Sodium-glucose cotransporter-2 inhibitors increase urinary tract infections?—a cross sectional analysis of a nationwide Japanese claims database. Endocr J. 2023;70(11):1103–7.
Kaur R, Kaur R. Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgraduate Medical Journal. 1o de dezembro de 2021;97(1154):803–12.
Timm MR, Russell SK, Hultgren SJ. Urinary tract infections: pathogenesis, host susceptibility and emerging therapeutics. Nat Rev Microbiol. fevereiro de 2025;23(2):72–86.
Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. The American Journal of Medicine. julho de 2002;113(1):5–13.
Jia H, Su W, Zhang J, Wei Z, Tsikwa P, Wang Y. Risk factors for urinary tract infection in elderly patients with type 2 diabetes: A protocol for systematic review and meta-analysis. Kokori E, organizador. PLoS ONE. 26 de setembro de 2024;19(9):e0310903.
Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global trends in diabetes complications: a review of current evidence. Diabetologia. janeiro de 2019;62(1):3–16.
Salari N, Karami MM, Bokaee S, Chaleshgar M, Shohaimi S, Akbari H, et al. The prevalence of urinary tract infections in type 2 diabetic patients: a systematic review and meta-analysis. Eur J Med Res. 5 de fevereiro de 2022;27(1):20.
Nunes CP, Giusti CT. EFICÁCIA E EVENTOS ADVERSOS DOS INIBIDORES DE SGLT2. Revista da Faculdade de Medicina de Teresópolis. 15 de dezembro de 2020; 4(1):14-21.
Hsu TL, Liu FH, Sun JH, Lin YH, Tsai CY, Lin CH. Cardiovascular Outcomes of Patients With Type 2 Diabetes With Urinary Tract Infection Post Sodium-Glucose Cotransporter 2 Inhibitors Treatment: A Multicenter Observational Study. Endocrine Practice. maio de 2025;31(5):592–8.
De Sousa MNA, Bezerra ALD, Do Egypto IAS. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. OLEL. 24 de outubro de 2023;21(10):18448–83.
Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. 3a ed. Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins; 2011.
Li CX, Liu LY, Zhang CX, Geng XH, Gu SM, Wang YQ, et al. Comparative safety of different sodium-glucose transporter 2 inhibitors in patients with type 2 diabetes: a systematic review and network meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne). setembro de 2023;14:1238399– 1238399.
Danysh HE, Johannes CB, Beachler DC, Layton JB, Ziemiecki R, Arana A, et al. Post-Authorization Safety Studies of Acute Liver Injury and Severe Complications of Urinary Tract Infection in Patients with Type 2 Diabetes Exposed to Dapagliflozin in a Real-World Setting. Drug Saf. 2023;46(2):175–93.
P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra State, India, Ferwani P, Maldar A, Shah N, Shah P, Chadha M. Prevalence of Bacterial Urinary Tract Infection Among Patients With Type 2 Diabetes Mellitus on Sodium-Glucose Cotransporter-2 Inhibitors: A Prospective Real-World Setting Study. JAFES. 25 de novembro de 2022;37(2):5–8.
Alkabbani W, Zongo A, Minhas-Sandhu JK, Eurich DT, Shah BR, Alsabbagh MW, et al. Sodium-Glucose Cotransporter-2 Inhibitors and Urinary Tract Infections: A Propensity Score–matched Population-based Cohort Study. Canadian Journal of Diabetes. junho de 2022;46(4):392-403.e13.
Iordan L, Avram VF, Timar B, Sturza A, Popescu S, Albai O, et al. Safety of SGLT2 Inhibitors and Urinary Tract Infections in Clinical Practice-A Cross-Sectional Study. Medicina (Kaunas). 1o de dezembro de 2024;60(12):1974.
Mashraqi MM, Chaturvedi N, Alam Q, Alshamrani S, Bahnass MM, Ahmad K, et al. Biocomputational Prediction Approach Targeting FimH by Natural SGLT2 Inhibitors: A Possible Way to Overcome the Uropathogenic Effect of SGLT2 Inhibitor Drugs. Molecules. 22 de janeiro de 2021;26(3):582.
Ueda M, Zenibayashi M, Yamada T, Asahara SI, Ogawa W. Comparison over Time of Adverse Drug Reactions in Diabetes Patients Treated with Sodium-Glucose Cotransporter 2 Inhibitors. Kobe J Med Sci. agosto de 2024;70(3):E81–8.
Chen L, Xue Q, Yan C, Tang B, Wang L, Zhang B, et al. Comparative safety of different recommended doses of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis of randomized clinical trials. Front Endocrinol (Lausanne). novembro de 2023;14:1256548–1256548.
Tanriverdi M, Bastemir M, Demirbakan H, Ünalan A, Türkmen M, Tanriverdi GÖ. Association of SGLT-2 inhibitors with bacterial urinary tract infection in type 2 diabetes. BMC Endocr Disord. outubro de 2023;23(1):211–211.
Lin DSH, Lee JK, Chen WJ. Clinical Adverse Events Associated with Sodium-Glucose Cotransporter 2 Inhibitors: A Meta-Analysis Involving 10 Randomized Clinical Trials and 71 553 Individuals. J Clin Endocrinol Metab. 2021;106(7):2133–45.
Benjamin T, Schumacher C. Characterization of Risk Factors for Genitourinary Infections with Sodium‐Glucose Cotransporter‐2 Inhibitors. Pharmacotherapy. outubro de 2020;40(10):1002–11.
Anan G, Kikuchi D, Omae K, Hirose T, Okada K, Mori T. Sodium-glucose cotransporter-2 inhibitors increase urinary tract infections?—a cross sectional analysis of a nationwide Japanese claims database. Endocr J. 2023;70(11):1103–7.
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2025-11-19
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Souza, E. F. R. de, Junior, B. da S. L., Farias, G. C., & Almeida, N. C. C. de. (2025). La influencia de los inhibidores de SGLT2 en el riesgo de infección del tracto urinario en pacientes con Diabetes Mellitus tipo 2: una revisión integrativa de la literatura. O Mundo Da Saúde, 49. https://doi.org/10.15343/0104-7809.202549e17482025I
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Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
