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From glucosuria to dialysis: a case report of osmotic nephropathy due to an SGLT2 inhibitor - PubMed

7 days ago
  • #Osmotic nephropathy
  • #SGLT2 inhibitors
  • #Acute kidney injury
  • Osmotic nephropathy is a rare drug-induced complication linked to SGLT2 inhibitors like empagliflozin.
  • A 49-year-old man with diabetes and hypertension developed acute kidney injury after chronic empagliflozin use, requiring dialysis.
  • Renal biopsy confirmed osmotic nephropathy, characterized by tubular vacuolization due to hyperosmolar intratubular pressure from glucosuria.
  • Management involves discontinuing the offending drug and supportive care; SGLT2 inhibitors should be paused during dehydration or diarrhea.
  • Predisposing factors include diabetes, advanced age, and pre-existing kidney impairment.