ALB and diabetic kidney disease: While H-K ATPase is not directly associated with albumin excretion, we propose that vonoprazan may have an effect similar to SGLT2 inhibitors, considering that renal ion transporters are integral to the complex pathophysiological mechanisms of diabetic kidney disease (DKD) and the recent clinical benefits of sodium–glucose cotransporter 2 (SGLT2) inhibitors in DKD highlight the crucial role of renal ion homeostasis in disease progression20,21.