Figure 6.

Proposed effects of Na⁺-glucose cotransporter 2 (SGLT2) inhibitor and loop diuretic on vasopressin and fluid homeostatic responses. A: the increase in serum Na⁺ and Cl⁻ concentrations mainly due to osmotic diuresis by SGLT2 inhibitor induces vasopressin release, which stimulates fluid intake and free water reabsorption. These compensatory mechanisms in response to a diuretic action of SGLT2 inhibitor maintains fluid balance (fluid intake – urine volume), body fluid volume, and renal function. B: the decrease in serum Na⁺ and Cl⁻ concentrations due to natriuresis and the reduction of food intake by furosemide attenuated vasopressin release, which fails to stimulate fluid intake and free water reabsorption. As a result, loop diuretic induces a negative fluid balance and the reduction in body fluid volume and potentially reduces renal function.