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SGLT2 Inhibition and Acute Kidney Injury Friend or Foe?
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a novel class of antidiabetic medications that have been demonstrated to improve cardiovascular outcomes in patients with diabetes. SGLT2 inhibitors regulate serum glucose levels by selectively blocking type 2 glucose transporters in the proximal convoluted tubules, thereby reducing the amount of glucose and sodium reabsorbed. Increased delivery of sodium and chloride to the macula densa induces tubuloglomerular feedback, leading to constriction of the renal afferent arteriole and to reduction of intraglomerular pressure and albuminuria. Also, these medications have been shown to reduce cellular oxidative stress and to improve energy balance. Whereas SGLT2 proteins are markedly
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