How much decrease in eGFR do you tolerate before discontinuing a SGLT2i started in patients with diabetic kidney disease?

SGLT2i are known to have an acute, reversible dip in eGFR in the first 2-4 weeks after initiation. This effect on glomerular hemodynamics (more pronounced in diabetics) usually decreases eGFR by less than 30% and has been associated with better long-term cardio-renal benefits in some studies. A dip in eGFR of more than 30% was reported in 0.5% of canagliflozin-treated patients (CREDENCE trial) and was associated with a higher risk of adverse kidney events

Early studies with SGLT2i noted an increa...