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One example of how cells use the energy contained in electrochemical gradients is demonstrated by glucose transport into cells. The ion vital to this process is sodium (Na+), which is typically present in higher concentrations extracellularly than in the cytosol. Such a concentration difference is due, in part, to the action of an enzyme "pump" embedded in the cellular membrane that actively expels Na+ from a cell. Importantly, as this pump contributes to the high concentration of...
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Related Experiment Video

Updated: Jun 4, 2025

Single-channel Analysis and Calcium Imaging in the Podocytes of the Freshly Isolated Glomeruli
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SGLT2-Inhibition in Patients With Alport Syndrome.

Jan Boeckhaus1, Daniel P Gale2,3, James Simon4

  • 1Clinic for Nephrology and Rheumatology, University Medical Center Goettingen, Germany.

Kidney International Reports
|December 19, 2024
PubMed
Summary

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) significantly reduced albuminuria in Alport syndrome (AS) patients. Further research is needed to confirm long-term kidney protection with SGLT2i in AS.

Keywords:
Alport syndromeCOL4albuminuriadapagliflozinempagliflozinkidney failure

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Area of Science:

  • Nephrology
  • Pharmacology

Background:

  • Chronic kidney disease (CKD) management benefits from sodium-glucose cotransporter-2 inhibitors (SGLT2i) in adults.
  • The efficacy and safety of SGLT2i in Alport syndrome (AS), a hereditary CKD, remain under-investigated in larger patient cohorts.

Purpose of the Study:

  • To assess the safety and effectiveness of SGLT2i in patients with Alport syndrome (AS).
  • To evaluate the impact of SGLT2i on albuminuria levels in AS patients.

Main Methods:

  • An observational, multicenter, international study (NCT02378805) involving 112 AS patients initiating SGLT2i therapy.
  • Primary endpoint: change in albuminuria (albumin/g creatinine) from baseline.
  • Follow-up extended up to 32 months, with assessments at multiple intervals post-therapy initiation.

Main Results:

  • Significant albuminuria reduction (>30%) observed at early follow-up visits (months 1-15) compared to baseline.
  • Mean estimated glomerular filtration rate (eGFR) loss of 9 ± 12 ml/min/1.73 m² approximately one year after SGLT2i initiation.
  • Low rate of adverse events (0.24 per patient-year) reported during 71 patient-years at risk.

Conclusions:

  • SGLT2i, when added to renin-angiotensin system inhibition (RASi), show potential in reducing albuminuria in AS patients.
  • Long-term studies are necessary to determine if SGLT2i-induced albuminuria reduction translates to delayed kidney failure (KF) in AS.
  • SGLT2i appear to be a safe therapeutic option for AS patients, warranting further investigation into their long-term renal protective effects.