Do you recommend decreasing the loop diuretic dose when starting an SGLT2 inhibitor in a CKD patient given its natriuretic and osmotic diuretic effects?  

The decision to continue or not a loop diuretic when starting an SGLT2 inhibitor should be individualized based on the patient's blood pressure/volume status.In general, if a patient's blood pressure/volume status is high, like in the setting of heart failure, SGLT2 inhibitors, and loop diuretics ar...

I routinely stop loop diuretics when starting a patient on SGLT2I therapy. I tell my patients that they should weigh themselves in the morning and if they lose more than 2 pounds in any 24-hour period, they need to increase their fluid intake. This record works best when it is written down. If they...