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SGLT2 Inhibitors for the Management of IgA Nephropathy: A New Therapeutic Paradigm for an Old Entity?

  • 1 George Vasquez-Rios, MD, is with the Division of Nephrology, Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
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Immunoglobulin A nephropathy (IgAN) is the most common glomerular disease worldwide (1). The prevalence varies geographically, and estimates of disease burden depend on the registry data assessed. The pathophysiology of this condition includes circulating and glomerular immune complexes comprised of galactose-deficient IgA1, an IgG autoantibody (directed against the hinge region O-glycan), and C3 (1). Experimental models suggest that environmental factors can trigger aberrant IgA production in highly active sites such as the mucosal-associated lymphoid tissue (MALT) in the gastrointestinal tract, which ultimately leads to immune complex deposition in key compartments of the kidney. Mesangial cells serve

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