Would you recommend starting an SGLT2 inhibitor in a proteinuric CKD patient with chronic asymptomatic bacteriuria?

In spite of the biological plausibility that SGLT2 inhibitors are associated with increased risk for UTI, population-based cohort studies, like the one of Dave et al in diabetic patients, did not show a higher risk of severe or minor UTI with SGLT2 inhibitor users and other antidiabetic drugs. The d...

I would certainly prescribe SGLT2-I’s for all Type 2 diabetic patients with GFRs over 25 ml/min. Apart from reducing kidney disease progression, they also reduce the risk of cardiovascular hospitalization and modestly lower both systolic and diastolic blood pressure.

If the patient has a UTI, it can...