Elena Guillén-Olmos

ALT Visual Abstract for the article titled "The Association of Background Medications on Initial eGFR Change and Kidney Outcomes in Diabetic Patients Receiving SGLT2 Inhibitor"

ALT (A) Albumin uptake and processing by the proximal tubule. Albumin filtered across the glomerulus into Bowman’s Space is reabsorbed by both receptor-mediated endocytosis of clathrin-coated vesicles, mediated by binding to the apical megalincubilin receptor, and fluid-phase endocytosis or clathrin independent endocytosis. Following uptake albumin can be transcytosed, mediated by dissociation from the megalin-cubilin complex and subsequent binding to neonatal Fc receptor (FcRn) in the acidic endosomal environment, or undergo catabolism via lysosomal trafficking and degradation (nonbinding FcRn albumin). Albumin fragments in the urine result from lysosomal exocytosis of partially degraded albumin or peptide hydrolysis by apical membrane proteases.