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Sunday, May 30, 2021

Topic Discussion: SGLT2i and the Kidney

 


Two tweetorials I had recently done on the benefits of SGLT2 inhibitors

Here is a table summary of what exists on benefits of various things in Nephrology


SGLT2i  benefit

Summary or Major Reference

Diabetic Kidney Disease

https://onlinelibrary.wiley.com/doi/full/10.1002/clc.23508

 

IgA Nephropathy

https://www.kidney-international.org/article/S0085-2538(21)00396-3/fulltext

 

SIADH

https://jasn.asnjournals.org/content/31/3/615.abstract

 

Hypomagnesemia

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380494/

 

Kidney Stones Prevention

https://link.springer.com/article/10.1007/s00125-021-05424-4

 

Anemia of CKD

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30300-4/fulltext

 

Prevent AKI

https://cjasn.asnjournals.org/content/16/1/70.abstract

 

Prevention of cisplatin AKI

https://journals.physiology.org/doi/full/10.1152/ajprenal.00512.2019

 

 

Monday, May 17, 2021

COVID19 vaccine induced glomerular diseases?- a literature update May 2021

The vaccine for COVID19 has been a lifesaver for many around the world. As expected, as you upregulate your immune system- you are going to get some flare ups of your immune system. Thus far, what are we noticing Minimal change disease, MN and IgA nephropathy. 

Several published cases of podocytopathies- mainly minimal change disease- either de-novo or relapse have been reported ( 4 cases thus far)

https://www.kidney-international.org/article/S0085-2538(21)00493-2/fulltext (Pfizer-BioNTech )

https://www.sciencedirect.com/science/article/pii/S0272638621005096 (Pfizer-BioNTech) 

https://www.ajkd.org/article/S0272-6386(21)00602-8/fulltext ( Pfizer-BioNTech )

https://www.kidney-international.org/article/S0085-2538(21)00478-6/fulltext (Pfizer-BioNTech)

IgA nephropathy flaring up has been reported ( 3 cases thus far)

https://www.kidney-international.org/article/S0085-2538(21)00465-8/fulltext ( Moderna)

https://www.kidney-international.org/article/S0085-2538(21)00286-6/fulltext (Moderna)

Relapse of Membranous Nephropathy  ( one case)

https://www.kidney-international.org/article/S0085-2538(21)00494-4/fulltext (Sinovac’s COVID-19 vaccine.)

Acute transplant rejection has been reported

https://www.kidney-international.org/article/S0085-2538(21)00466-X/fulltext Pfizer-BioNTech)

While we cannot be totally sure if this is vaccine related- timing maybe a factor. I am sure there will be many more to be added to this list.

Despite this, the vaccine saves lives! Remember severe COVID19 disease led to significant AKI and ATN and even several cases of glomerular diseases. Such vaccine associated immune responses should not deter one from getting vaccinated. Overall, even the flu vaccine and other vaccines have been associated with several glomerular diseases such as MCD and membranous nephropathy.  Given mass vaccinations happening around the world, there will be cases of vaccine induced GNs( but still very very rare)