Can GLP-1 Receptor Agonists Cause Urinary Tract Infections?
No, GLP-1 receptor agonists do not cause urinary tract infections. There is no evidence in the medical literature linking GLP-1 receptor agonists (such as semaglutide, tirzepatide, liraglutide, or dulaglutide) to an increased risk of UTIs.
Why This Question Arises
You may be confusing GLP-1 receptor agonists with SGLT2 inhibitors (such as empagliflozin, dapagliflozin, or canagliflozin), which do increase the risk of genitourinary infections, including UTIs and genital yeast infections 1, 2. SGLT2 inhibitors work by causing glucose to spill into the urine, creating a sugar-rich environment in the urinary tract that promotes bacterial and fungal growth 1, 2.
Actual Side Effects of GLP-1 Receptor Agonists
The most common adverse effects of GLP-1 receptor agonists are gastrointestinal, not genitourinary 1, 3, 4:
- Nausea (17–44% of patients) – typically mild-to-moderate, dose-dependent, and decreases over time 1, 3
- Diarrhea (12–32% of patients) 1
- Vomiting (6–25% of patients) 1, 3
- Constipation (10–23% of patients) 1
- Abdominal pain 1
These gastrointestinal effects occur because GLP-1 receptor agonists delay gastric emptying by inhibiting gastric peristalsis and increasing pyloric tone through vagal pathways 2, 4.
Renal Effects (Not UTIs)
While GLP-1 receptor agonists do affect the kidneys, these effects are protective, not harmful 1, 5, 6:
- Reduce albuminuria (protein in urine) and slow the decline in kidney function 1, 5, 6
- Increase glomerular filtration rate (GFR) acutely by approximately 18–20% 5
- Increase renal plasma flow by approximately 14% 5
- No dose adjustment required across all stages of chronic kidney disease, including severe renal impairment 1
Acute kidney injury (AKI) has been reported in some cases, but this is primarily due to dehydration from severe gastrointestinal side effects (nausea, vomiting, diarrhea), not a direct toxic effect on the kidneys 3, 7. Liraglutide showed the strongest association with AKI in post-marketing surveillance data, with a median onset time of 63 days 7.
Common Pitfalls to Avoid
- Do not confuse GLP-1 receptor agonists with SGLT2 inhibitors – only SGLT2 inhibitors increase UTI risk 1, 2
- Monitor for dehydration in patients experiencing severe gastrointestinal side effects, as this can lead to acute kidney injury 3, 7
- Educate patients that increased urination is not a side effect of GLP-1 receptor agonists (unlike SGLT2 inhibitors) 1, 2
Bottom Line
If you are taking a GLP-1 receptor agonist and develop a UTI, it is coincidental, not caused by the medication 1, 2, 3, 4. The medication class does not increase UTI risk and has no mechanism that would predispose to urinary tract infections 1, 2.