Multimorbidity in nephrotic syndrome

Area of Science:

• Nephrology
• Endocrinology
• Pharmacology

Background:

• Nephrotic syndrome (NS) presents with significant proteinuria, edema, and hypercoagulation.
• Common causes include primary glomerulonephritis and secondary conditions like diabetes, inflammatory diseases, and infections.
• Diabetic nephropathy is a leading cause of NS in adults, contributing to nearly 40% of dialysis patients.

Purpose of the Study:

• To explore the nephroprotective effects of SGLT2 inhibitors (gliflozins) in managing nephrotic syndrome.
• To understand the mechanism of action of gliflozins, including their impact on glycosuria, natriuresis, and osmotic diuresis.

Main Methods:

• Review of existing literature on nephrotic syndrome and SGLT2 inhibitors.
• Analysis of the physiological effects of SGLT2 inhibition on renal function.

Main Results:

• SGLT2 inhibitors increase urinary glucose excretion (glycosuria) and sodium excretion (natriuresis).
• This leads to osmotic diuresis, potentially reducing glomerular hyperfiltration.
• The natriuretic effect of SGLT2 inhibitors is maintained across all stages of renal insufficiency.

Conclusions:

• Gliflozins demonstrate a positive nephroprotective effect, particularly relevant for diabetic nephropathy-associated NS.
• Their mechanism involves promoting natriuresis and diuresis, offering a therapeutic avenue for kidney protection in NS patients.