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Question

A rare genetic disorder affects the sodium-glucose cotransporter SGLT2 in the proximal convoluted tubule, rendering it non-functional. Which of the following would be the MOST prominent consequence?

Mr. BALACHANDRA.N · Accepted Answer

## CORE INFORMATION
✓ **Answer**: [Option C]
## CONCEPT FRAMEWORK
	**Primary Concept**: Sodium-glucose reabsorption in renal physiology
	**Related Topics**: Renal handling of glucose, diabetes mellitus, transport mechanisms
	**Prerequisites**: Understanding of renal physiology, particularly nephron function and transporters
## SOLUTION PATHWAY
**Given Information**:
		- The sodium-glucose cotransporter SGLT2 is non-functional.
		- SGLT2 is responsible for reabsorbing glucose in the proximal convoluted tubule.
**Method & Steps**:
	1. The primary function of SGLT2 is to reabsorb glucose along with sodium from the renal filtrate back into the blood.
		Reasoning: When SGLT2 is non-functional, glucose cannot be reabsorbed effectively.
		Formula/Rule: The reabsorption process is dependent on the sodium concentration gradient which is maintained by Na+/K+ ATPase.
	2. With impaired glucose reabsorption, excess glucose remains in the renal tubules and is excreted in the urine.
		Working: This leads to glucosuria (increased glucose in urine).
		Key Point: The renal threshold for glucose is exceeded, resulting in glucose loss through urination.
	3. The consequence of this loss is that the body will not be able to retain glucose, which can lead to osmotic diuresis.
		Result: Increased glucose excretion in urine is the most prominent consequence of SGLT2 dysfunction.
		Verification: This aligns with clinical observations in conditions like diabetes mellitus where SGLT2 inhibitors are used to promote glucose excretion in urine.
## OPTION ANALYSIS
[A] :x: Metabolic alkalosis is not a direct consequence of SGLT2 dysfunction; it relates to acid-base balance, not glucose reabsorption. 
[B] :x: Increased water reabsorption is not expected; in fact, osmotic diuresis may lead to decreased water reabsorption due to glucose presence in urine. 
[C] ✓: Increased glucose excretion in urine is the correct consequence of non-functional SGLT2, leading to glucosuria. 
[D] :x: Decreased sodium excretion in urine is incorrect; sodium reabsorption is also affected, potentially increasing sodium loss in urine. 
## LEARNING AIDS
	**Common Mistakes**:
		1. Confusing glucose excretion with increased reabsorption: Remember that if SGLT2 is non-functional, glucose will not be reabsorbed.
		2. Overlooking the role of osmotic diuresis in glucosuria: This condition leads to water loss due to high solute concentration in urine.
	**Quick Tips**:
		1. Remember that SGLT2 plays a key role in glucose and sodium reabsorption—its dysfunction leads to loss of both in urine.
		2. Associate glucosuria with diabetes treatments that inhibit SGLT2, as it demonstrates the clinical relevance of glucose handling in the kidneys.

Mr. BALACHANDRA.N · Answer

Metabolic alkalosis

Mr. BALACHANDRA.N · Answer

Increased water reabsorption

Mr. BALACHANDRA.N · Answer

The correct Option is "Increased glucose excretion in urine"

Mr. BALACHANDRA.N · Answer

Decreased sodium excretion in urine

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