Compared among DKD-related AE lesion and our SGLT2-related osmotic vacuolization of proximal tubular epithelial cells, osmotic diuresis due to excretion of large amounts of sugar into urine and dehydration were common factors and might contribute to vacuolization of proximal tubules, although our cases did not show markedly hyperglycemia. The gene discussed is SLC5A2; the disease is Hyperglycemia.