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why do we get natriuresis with SGLT2i?
Could it just be the simple fact that the & #39;S& #39; in SGLT2i stands for sodium - so blocking sodium reabsorbtion in PT = natriuresis?
Alicia McDonough robs me of that simplistic thinking at the #KidneyWk talk on this (h/t @VelezNephHepato)
Could it just be the simple fact that the & #39;S& #39; in SGLT2i stands for sodium - so blocking sodium reabsorbtion in PT = natriuresis?
Alicia McDonough robs me of that simplistic thinking at the #KidneyWk talk on this (h/t @VelezNephHepato)
Firstly, SGLT2i can increase even the paracellular Na *secretion*
From this @CO_Neph_Hype review https://pubmed.ncbi.nlm.nih.gov/31815757/ ">https://pubmed.ncbi.nlm.nih.gov/31815757/...
#KidneyWk
From this @CO_Neph_Hype review https://pubmed.ncbi.nlm.nih.gov/31815757/ ">https://pubmed.ncbi.nlm.nih.gov/31815757/...
#KidneyWk
But most of her talk was focused on the NHE3, colacalized with SGLT2i on the proximal tubule
(note the SGLT2i in use have a little bit SGLT1 inhibition - the one with the most Sotagliflozin RCT SCORED will be at AHA)
#KidneyWk
(note the SGLT2i in use have a little bit SGLT1 inhibition - the one with the most Sotagliflozin RCT SCORED will be at AHA)
#KidneyWk
NHE3 reabsorbs Na; the H+ gets recycled
so inhibition of NHE3 = more natriuresis
so SGLT2i inhibition of NHE3 would make a lot of sense. How does it occur? SOme intriguing data on MAP17 mediation here https://journals.physiology.org/doi/abs/10.1152/ajpcell.00275.2019?journalCode=ajpcell">https://journals.physiology.org/doi/abs/1...
#KidneyWk
so inhibition of NHE3 = more natriuresis
so SGLT2i inhibition of NHE3 would make a lot of sense. How does it occur? SOme intriguing data on MAP17 mediation here https://journals.physiology.org/doi/abs/10.1152/ajpcell.00275.2019?journalCode=ajpcell">https://journals.physiology.org/doi/abs/1...
#KidneyWk
More here https://pubmed.ncbi.nlm.nih.gov/32893663/ ">https://pubmed.ncbi.nlm.nih.gov/32893663/... in @AJPRenal
(as an aside NHE3 also causes more bicarbonaturia - which is how NHE3 activity is measured)
#KidneyWK
(as an aside NHE3 also causes more bicarbonaturia - which is how NHE3 activity is measured)
#KidneyWK
This role of NHE3 inhibition in the proximal tubule may also be significant in heart failure as shown in this @biorxivpreprint https://www.biorxiv.org/content/10.1101/2020.07.16.207118v1.full
https://www.biorxiv.org/content/1... href="https://twtext.com//hashtag/KidneyWK"> #KidneyWK
#KidneyWK" title="This role of NHE3 inhibition in the proximal tubule may also be significant in heart failure as shown in this @biorxivpreprint https://www.biorxiv.org/content/1... href="https://twtext.com//hashtag/KidneyWK"> #KidneyWK" class="img-responsive" style="max-width:100%;"/>
She recommends this nice review in @hyperaha https://pubmed.ncbi.nlm.nih.gov/32114848/ ">https://pubmed.ncbi.nlm.nih.gov/32114848/... from Chris Wilcox which puts most things we know about the topic together nicely
#KidneyWk
#KidneyWk
