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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 al 1 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 …
Contributors The writing of the manuscript was done by the DLJ and JPMG. The rest of the authors have made a critical revision of the literature.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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