Abstract
AbstractWe encountered 3 cases of acute kidney injury that occurred after treatment with a SGLT2 inhibitor. In case 1, serum creatinine increased from 1.65 to 3.0 mg/dL, in case 2, serum creatinine increased from 1.03 to 1.21 mg/dL, and in case 3, serum creatinine increased from 0.8 to 1.1 mg/dL. Renal biopsy showed isometric vacuolization on tubules, that was completely negative for Periodic acid-Schiff (PAS) stain in case 1, and was partially negative for PAS stain in case 2 and 3, consistent with osmotic vacuolization. Immunohistochemical analysis showed positive staining for CD138 and CD10 indicating the proximal tubules in the vacuolar lesions. 3 patients were obese with body mass index of more than 30, and showed an increase in serum renin. In conclusion, in type II diabetes mellitus (T2DM), individuals that remain within their standard weight range, SGLT2 inhibitor treatment does not result in osmotic vacuolization of proximal tubular epithelial cells and AKI. However, treatment with a SGLT2 inhibitor may cause damage of the proximal tubules resulting in AKI in T2DM individuals who do not remain within their standard weight range, due to an overdose lavage of sugar in the urine and dehydration.
Publisher
Springer Science and Business Media LLC
Subject
General Earth and Planetary Sciences,General Environmental Science
Reference12 articles.
1. Shubrook JH, Bokaie BB, Adkins SE. Empagliflozin in the treatment of type 2 diabetes: evidence to date. Drug Des Dev Ther. 2015;30(9):5793–803.
2. Haas B, Eckstein N, Pfeifer V, Mayer P, Hass MDS. Efficacy, safety and regulatory status of SGLT2 inhibitors: focus on canagliflozin. Nutr Diabetes. 2014;4(11):e143.
3. Hiramatsu R, Hoshino J, Suwabe T, Sumida K, Hasegawa E, Yamanouchi M, Hayami N, Sawa N, Takaichi K, Ohashi K, Fujii T, Ubara Y. Membranoproliferative glomerulonephritis and circulating cryoglobulins. Clin Exp Nephrol. 2014;18(1):88–94.
4. Bonsib SM. Renal anatomy and histology. In: Jennette JC, Olson JL, Silva FG, D’Agati VD, editors. Heptinstall’s pathology of the kidney. 7th ed. Philadelphia: Wolters Kluwer; 2014. p. 1–66.
5. Kawamoto S, Koda R, Yoshino A, Takeda T, Ueda Y. Rapidly progressive renal dysfunction in two elderly patients with renal enlargement and medullary cystic kidney disease-like acute tubulointerstitial injury. Intern Med. 2016;55(20):3001–7.
Cited by
10 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献