Hypertension in CKD — ESENeph MCQ

Correct answer: E — Temporarily withhold dapagliflozin until recovery

The best answer is “Temporarily withhold dapagliflozin until recovery”. UKKA recommends temporarily withholding SGLT2 inhibitors during acute illness. The patient should maintain appropriate hydration, seek review for deterioration or ketoacidosis symptoms, and restart once eating, drinking and clinically stable. “Double dapagliflozin to preserve the chronic kidney benefit” is less appropriate because acute volume depletion increases adverse-event risk and is an indication for temporary interruption “Continue dapagliflozin until creatinine has doubled” is less appropriate because waiting for established kidney injury defeats preventive sick-day guidance “Replace dapagliflozin immediately with a second SGLT2 inhibitor” is less appropriate because the concern is a class effect during acute illness rather than the specific molecule “Stop dapagliflozin permanently after every minor illness” is less appropriate because the recommendation is a temporary interruption with review and restart after recovery

Reference: UK Kidney Association SGLT2 guideline: acute illness: https://guidelines.ukkidney.org/sodium-glucose-co-transporter-2/5c-acute-kidney-injury-hypovolaemia-and-potassium/