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Do you routinely discontinue SGLT2 inhibitors during febrile illness or acute infection in patients with diabetic kidney disease due to concern for volume depletion?

4 Answers
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Nephrology · Penn Medicine Cherry Hill

Yes, I generally advise patients to hold while ill.

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Nephrology · The University of Texas Health Science Center at San Antonio

I do not. Indeed, SGLT2i have a modest diuretic effect, but I also don't routinely stop other diuretics, eg loop, thiazides or K sparing, in settings of fever or infection, either. That decision is individualized based on my assessment of volume status.

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Nephrology · UCLA

I would temporarily hold SGLT2 inhibitors during febrile illness or acute infection in patients with diabetic kidney disease if they are at risk of volume depletion (i.e. reduced oral intake, vomiting or diarrhea, high fevers with insensible fluid losses). Holding SGLT2 inhibitors in these acutely i...

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Nephrology · University Of California San Francisco Medical Center At Parnassus

Yes. Short term benefits of SGLT-2 are minimal but risk of worsening infection is there. I would hold them until infection is resolved.

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