Recent clinical studies indicate that
sodium glucose cotransporter 2 (SGLT2) inhibitors exhibit a renoprotective
effect. However, the mechanism underlying this effect has not been fully
elucidated. The article by Takakura and Takasu found that single intravenous
injection of ipragliflozin, a selective SGLT2 inhibitor, at a dose that increased
glucose excretion reduced creatinine clearance without affecting systemic blood
pressure in type 2 diabetic mellitus STD-fatty rats. These results suggest that
SGLT2 inhibition directly reduces whole-kidney glomerular filtration rate, most
likely due to a reduction in intraglomerular pressure, by altering local renal hemodynamics.
This effect might explain the renoprotective effects demonstrated in clinical
studies, at least partly.