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SGLT2i UTI Management — ESENeph MCQ

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EasyDiabetic Kidney DiseaseSGLT2i UTI ManagementESENeph

A 40-year-old woman with type 2 diabetes and CKD G3b is on Empagliflozin 10 mg. She develops a urinary tract infection with E.coli. Her symptoms are mild (dysuria, frequency). Should Empagliflozin be continued?

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Correct answer: A — Mild uncomplicated UTI can be treated with antibiotics while continuing Empagliflozin; only stop for complicated or recurrent UTI

SGLT2i increase UTI risk slightly through glycosuria but the absolute risk increase is small. For mild uncomplicated UTI, standard antibiotic treatment is sufficient and SGLT2i can generally be continued. KDIGO 2024 practice point suggests withholding SGLT2i during serious illness (sepsis, pyelonephritis) but not for simple cystitis. The renoprotective benefits of SGLT2i far outweigh the modest UTI risk in most patients.

Reference: KDIGO 2024 – CKD Guideline; DAPA-CKD Safety Data