SGLT2 Inhibition and Kidney Potassium Homeostasis.
Clin J Am Soc Nephrol
; 19(3): 399-405, 2024 03 01.
Article
in En
| MEDLINE
| ID: mdl-37639260
Pharmacologic inhibition of the sodium-glucose transporter 2 (SGLT2) in the proximal tubule brings about physiologic changes predicted to both increase and decrease kidney K + excretion. Despite these effects, disorders of plasma K + concentration are an uncommon occurrence. If anything, these drugs either cause no effect or a slight reduction in plasma K + concentration in patients with normal kidney function but seem to exert a protective effect against hyperkalemia in the setting of reduced kidney function or when given with drugs that block the renin-angiotensin-aldosterone axis. In this review, we discuss the changes in kidney physiology after the administration of SGLT2 inhibitors predicted to cause both hypokalemia and hyperkalemia. We conclude that these factors offset one another, explaining the uncommon occurrence of dyskalemias with these drugs. Careful human studies focusing on the determinants of kidney K + handling are needed to fully understand how these drugs attenuate the risk of hyperkalemia and yet rarely cause hypokalemia.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hyperkalemia
/
Hypokalemia
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Clin J Am Soc Nephrol
Journal subject:
NEFROLOGIA
Year:
2024
Document type:
Article
Country of publication:
United States