Anti Diabetics Sglt Inhibitor Glomerular Hyperfiltration

Hyperglycemic state without SGLT inhibitor drug:

Hyperglycemic state –> Increase Glu in tubules –> Increased absorption @ PCT via SGLT cotransporter –> More of sodium is absorbed absorbed along with Glu –> Less Na in tubule at DCT –> Macula densa thinks “hey, waay less sodium excreted, release Renin!” –> RAAS Activated –> ACE constricts eferent arteriole –> Increased Glomerular Filteration (Hyperfiltration)

SGLT-2 INHIBITION

SGLT-2 inhibitrs (-gliFs) in PCT –> Inc excretion of Na and Glu in urine –> Inc delivery of Na to macula densa –> No need of Renin! –> Less RAAS –> Less ACE –> Less constriction of eferentarteriole –> Reduction in Glomerular Filteration