How do you integrate perioperative dapagliflozin with hemodynamic optimization and nephrotoxin avoidance for AKI prevention in a patient undergoing elective cardiac surgery?
The MERCURI-2 trial showed dapagliflozin starting the day before surgery reduced postoperative AKI incidence from 52% to 28% without increased adverse events, despite current FDA guidance recommending SGLT-2 inhibitor discontinuation at least 3 days before major surgery.
1 Answer
Mednet MemberInvited Expert
Nephrology · UCLA
Answered on
At this time, I would not recommend perioperative dapagliflozin for the prevention of AKI in patients undergoing elective cardiac surgery. The primary outcome in the MERCURI-2 trial was a composite definition of AKI using the KDIGO criteria which incorporates changes in both serum creatinine and uri...
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