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SGLT2 inhibitor renal effects — SCE Endocrinology MCQ

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HardDiabetesSGLT2 inhibitor renal effectsSCE Endocrinology

A 61-year-old man with type 2 diabetes and albuminuria is started on empagliflozin. Two weeks later creatinine rises from 94 to 105 micromol/L; he is well and euvolaemic. What is the most appropriate interpretation?

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Correct answer: A — Expected early haemodynamic eGFR dip if clinically stable

A small early creatinine rise after SGLT2 inhibitor initiation can reflect haemodynamic eGFR dip and does not necessarily require stopping if the patient is stable. Larger rises, dehydration or acute illness would need reassessment. The pearl is to distinguish expected early change from true acute kidney injury.

Reference: NICE NG28; NICE NG203