Response to: Correspondence on 'Call for action in ANCA-associated vasculitis and lupus nephritis: promises and challenges of SGLT-2 inhibitors by Patoulias

We thank our colleague Dr Patoulias1 for pointing out that sodium glucose transporter (SGLT)-2 inhibition (SGLT-2i) could mediate nephroprotection in patients with lupus nephritis (LN) and ANCA-associated vasculitis (AAV) via specific mechanisms within the tubular cell compartment independent of the presence of diabetes mellitus.2 As discussed by Dr Patoulias, kidney injury molecule-1 (KIM-1) is affected by SGLT-2i correlating with improvements in albuminuria, a hallmark of chronic kidney damage. KIM-1, however, is not only a mere marker of tubular injury, but it is actively involved in diverse pathogenic actions. Hence, its expression, for example, in diabetic kidney disease accelerates kidney injury via fatty acid uptake coupled with tubular glucose reabsorption in renal proximal tubular cells, resulting in various detrimental stress responses.3 Upregulation of KIM-1 and the ensuing tubular cell responses illustrate the close relationship between diseased glomeruli and subsequent tubulointerstitial fibrosis in response to...
Source: Annals of the Rheumatic Diseases - Category: Rheumatology Authors: Tags: ARD Correspondence response Source Type: research