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Effect of sodium-glucose cotransporter-2 inhibitors on renal handling of electrolytes
  1. Priti Meena1,
  2. Vinant Bhargava1,
  3. Anil Bhalla1,
  4. Devinder Rana1,
  5. Alok Mantri2
  1. 1 Nephrology, Sir Ganga Ram Hospital, New Delhi, Delhi, India
  2. 2 Medicine, GB Pant Hospital, New Delhi, Delhi, India
  1. Correspondence to Dr Vinant Bhargava, Nephrology, Sir Ganga Ram City Hospital, New Delhi, Delhi 110060, India; Vinant.bhargava{at}


Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are the latest introduction into the armamentarium of diabetes care in the present decade. By virtue of their beneficial effects, such as blood pressure-lowering, bodyweight reduction and significant renal and cardioprotective effects which extends beyond their glycaemic control effects, SGLT2i have become one of the most preferred oral antihyperglycaemic agents of recent times. However, they can influence tubular handling of electrolytes that can result in some electrolyte disturbances such as alteration in the serum levels of magnesium, potassium and phosphate levels. Some of these changes are mild or transient and may not have significant clinical implications. The underlying putative mechanism(s) responsible for disturbances of electrolytes are yet to be deciphered. In this review, we aim to describe electrolytes and acid–base abnormalities due to SGLT2i as well as to elucidate the underlying mechanism.

  • physiology
  • clinical physiology
  • diabetes & endocrinology
  • diabetes & endocrinology
  • nephrology
  • adult nephrology

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  • Contributors PM contributed to conceptualisation and writing of original draft. VB was involved in supervision and validation. AB contributed to review and editing. DR did editing and supervised the manuscript writing. AM contributed to in planning, writing and validation of manuscript. Each author have participated in the writing and the preparation of the manuscript, and have seen and approved the submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.