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Letter to the Editor
Reply to ‘Effects of sodium-glucose cotransporter 2 inhibitors on urinary excretion of intact and total angiotensinogen in patients with type 2 diabetes’ by Yoshimoto et al.
  1. David León Jiménez1,
  2. Ramón Pérez Temprano2,
  3. Rocío Ruiz Hueso1,
  4. José Manuel Lopéz Chozas3,
  5. José Pablo Miramontes González4
  1. 1Department of Internal Medicine, Hospital Universitario Virgen Macarena, Sevilla, Andalucía, Spain
  2. 2Department of Internal Medicine, Vascular Unit, Hospital Universitario Virgen Macarena, Sevilla, Andalucía, Spain
  3. 3Department of Internal Medicine, Hospital Universitario Virgen del Rocio, Sevilla, Andalucía, Spain
  4. 4Department of Internal Medicine, Hospital Universitario de Salamanca, IBIS, Salamanca, Castilla y León, Spain
  1. Correspondence to Dr David León Jiménez, Department of Internal Medicine, Hospital Universitario Virgen Macarena, Sevilla, Andalucía 41009, Spain; daleji73{at}gmail.com

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To the editors,

In the study published in this journal by Yoshimoto et al,1 the authors show, for the first time in patients with Diabetes Mellitus (DM) type 2, the effect of sodium-glucose co-transporter 2 (SGLT2) inhibitors (iSGLT2) on the urinary excretion of angiotensinogen. As the urinary angiotensinogen is directly correlated with the renin–angiotensin system (RAS)2 activity into the kidney, the authors conclude that the iSGLT2 does not activate this system because there are no changes in the urinary angiotensinogen after the treatment.

We agree with the authors that the results should not be generalized and should be confirmed with additional studies because of the following four reasons.

First, the Yoshimoto et al1 study has been performed using different iSGLT2, even though they work in a similar way, they do not have the same potency blocking the SGLT2 receptors. In addition, the doses used are not comparable. For example, 100 mg of canagliflozin would …

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