Figure 3

SGLT2 Inhibitors and nephroprotection in diabetic kidney disease: From mechanisms of action to the latest evidence in the literature

Jorge Rico-Fontalvo, Rodrigo Daza-Arnedo, Maria Ximena Cardona-Blanco, Victor Leal-Martínez, Emilio Abuabara-Franco, Nehomar Pajaro-Galvis*, Jose Cabrales, José Correa, Manuel Cueto, Amable Duran, Alejandro Castellanos, Javier Enamorado, José Bohórquez, Isabella Uparella, Julio Zuñiga, Abraham Chagui, Alfonso Ramos and Luis Lara

Published: 21 August, 2020 | Volume 4 - Issue 2 | Pages: 044-055

jcn-aid1058-g003

Figure 3:

Effects of SGLT2 inhibitors in the diabetic nephron. SGLT2 inhibitors restore the delivery of solutes to the macular densa with the subsequent activation of adenosine and the reversal of the vasodilatation of the afferent arteriole. In patients treated with SGLT2 inhibitors, glucosuria, natriuresis and osmotic diuresis reduce the levels of glucose in the blood and lower blood pressure. By inhibiting the reabsorption of sodium at the level of SGLT2 as well as the sodium-hydrogen exchanger, the SGLT2 inhibitors restore the GFR with a decrease in the glomerular capillary pressure. The reduced reabsorption of glucose decreases local glucose toxicity. The improvement of the hypoxia in the renal cortex allows for differentiation of myofibroblasts in the EPO producing cells, reducing renal fibrosis and increasing EPO production [3,5].

Read Full Article HTML DOI: 10.29328/journal.jcn.1001058 Cite this Article Read Full Article PDF

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