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Effect of Sodium-Glucose Co-Transporter 2 Inhibitor on an Obese Patient with Long-Standing Type 2 Diabetes and Solitary Kidney

Serena Low and Su Chi LIM

An obese 62-year-old woman, with a prior history of left nephrectomy due to hydro nephrosis, had been on insulin therapy for the past ten years. Living with a solitary kidney (with presumptive hyper-filtration), her renal function remained preserved for decades. However, since 2015, her albuminuria deteriorated despite the addition of renin-angiotensinaldosterone system blockade medications. She was then treated with a sodium-glucose-co-transporter-2 (SGLT2) inhibitor. This resulted in improvement of her glycemic control, body mass index, blood pressure and near normalization of albuminuria. There is a need to further evaluate the reno-protective role of SGLT2 inhibitors in individuals with glomerular-hyperfiltration, which is related to obesity and usually occur during early phase of diabetic kidney disease.