Introduction
death, CKD, MCD, glycosuria, IgA nephropathy, Primary glomerular diseases, diabetic kidney disease, GN, treatment-resistant, end-stage renal disease, lupus nephritis, diabetic kidney diseases, diabetes
GLOMERULONEPHRITIS, MEMBRANOUS NEPHROPATHY, KIDNEY DISEASE, DIABETIC KIDNEY DISEASE, END STAGE RENAL DISEASE, MINIMAL CHANGE DISEASE, DIABETES MELLITUS, IGA NEPHROPATHY, FOCAL SEGMENTAL GLOMERULOSCLEROSIS (FSGS), END-STAGE RENAL DISEASE, CHRONIC KIDNEY DISEASE, LUPUS NEPHRITIS, DIABETES
There are two glucose transporters that are important for glucose reabsorption; both are in the proximal tubules of the kidneys: sodium–glucose cotransporter 1 (SGLT1), located in the S3 segment of the proximal tubule, and sodium–glucose cotransporter 2 (SGLT2), located in the S1 segment of the renal proximal tubule. SGLT2 are responsible for reabsorption of about 90% of the filtered glucose [Phlorizin (the precursor of all SGLT inhibitors) is an old natural compound derived from the bark of apple trees that was found to increase urinary glucose excretion [Sodium–glucose cotransporter-2 (SGLT2) inhibitors are novel class of oral antihyperglycemic medications. They exert antihyperglycemic effects by enhancing glucose excretion through renal tubules (glycosuria) through highly selective inhibition of SGLT2. The selectivity of this class markedly reduced gastrointestinal side effects that were associated with SGLT 1 inhibition [In 2014, the U.S. Food and Drug Administration approved two agents of the SGLT2 inhibitors: dapagliflozin and empagliflozin [Interestingly, in addition to their glycosuria effect, these agents were found to have beneficial metabolic effects which included uricosuric, blood pressure lowering and weight reduction effects [The beneficial effects of SGLT2 inhibitors on diabetic kidney diseases led to extending clinical trials to CKD patients due to causes other than diabetic kidney disease. The Dapagliflozin in Patients with Chronic Kidney Disease (DAPA-CKD) study was large phase 3 study to assess dapagliflozin in patients with CKD due to diabetes or any other cause. The study was powered for the renal outcomes. The progression to end-stage renal disease and death due to renal cause was lower in the dapagliflozin arm [The Empagliflozin in Patients with Chronic Kidney Disease (EMPA-KIDNEY), of empagliflozin is a large clinical trial that is powered for the prespecified renal outcomes in CKD not due to diabetes mellitus. The use of Empagliflozin has been shown to preserve renal function as compared to placebo [Glomerulonephritis (GN) describes a spectrum of inflammatory kidney disease. Advanced and treatment-resistant stages contribute to the burden of end stage renal disease [Primary glomerular diseases have wide spectrum of histopathological features including membranous nephropathy (MN), minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), IgA nephropathy and lupus nephritis (LN) [