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Proposed pathways of renal protective effects: firstly, SGLT2-inhibitors may reduce glomerular hyperfiltration through restoration of tubuloglomerular feedback, an effect which is mediated by increased sodium delivery to the distal tubule. Secondly, SGLT2-inhibitiors ameliorate renal oxygenation owing to reduced tubular workload. Thirdly, SGLT-2 inhibitors may exert anti-inflammatory and anti-fibrotic effects
