Would you avoid SGLT2 inhibitors in patients with nephrostomy tubes?

I probably would unless a compelling reason to use. I worry about risk of infection and would imagine that depending on the reason for the nephrostomy tubes might limit the potential upside of using these agents. Maybe in future years as we gain more experience in non-study populations my answer will change. A decision to use or avoid should involve patient input in decision making. I just think we don't really know the risk-benefit ratio in this type of patient.