Figure 1.

Possible mechanisms by which SGLT2 inhibitors influence the systemic and intrarenal RAS. SGLT2 inhibitors transiently increase plasma renin activity acutely through osmotic diuresis. Meanwhile, SGLT2 inhibitors decrease renal AGT expression by reducing glucose levels in the kidney. However, SGLT2 inhibitors can increase the glucose load in distal proximal tubule and that might increase the AGT production. SGLT2, sodium-glucose cotransporter 2; RAS, renin-angiotensin system; AGT, angiotensinogen. ↑, increase; ↓, decrease; →, no change; +, in case of plasma volume compensation; −, in case of no plasma volume compensation.