Would you add an SGLT2 inhibitor to augment diuresis during a hospitalization in a patient with nephrotic syndrome, an eGFR above 30 mL/min/1.73m2, and refractory hypervolemia on an intravenous loop diuretic?

Would you add an SGLT2 inhibitor to augment diuresis during hospitalization in a patient with nephrotic syndrome, an eGFR above 30 mL/min/1.73m², and refractory hypervolemia on an intravenous loop diuretic?

• Yes, I believe SGLT2 inhibitors can be effective in augmenting diuresis in this scenario
• No, I prefer using sequential diuretics (e.g., metolazone, thiazide-like diuretics, amiloride, or spironolactone) to address loop diuretic refractoriness
• No, I would add 25% albumin if there is evidence of intravascular volume depletion before considering other options
• No, I avoid using SGLT2 inhibitors as they cause increased water loss without significant sodium loss, which may not address the underlying hypervolemia
• Other