Dr. Jardine on side effects of SGLT2i. Where is evidence coming from? #Kidneywk 
Mostly is coming from CREDECE since it has the largest population of advanced CKD. Side effects are not different across different stages of CKD #Kidneywk
Hypoglycaemia not common, about 1%. DKA is rare (1 case per 1000 users) but real mostly seen in people who require insulin. #kidneywk
Some of the characteristics of DKA associated with SGLT2i . The most striking ones are lowish glucose levels and its association with fasting. Implementation of sick day rules may prevent some of these cases #Kidneywk
Amputations were only significant in #CANVAS. The major risk factor is history of another amputation. #CREDECE modified its protocol to reduce this risk. #Kidneywk
Fourniers Gangrene is very rare. Real world data was maybe driven for increased scrutiny of the new drugs. It remained a very rare event. 5.2/100000 persons years. Actually the risk may be even lower for people on #SGLT2i #kidneywk @drjjw
Volume depletion was not found int the clinical trials. No difference in UTIs . Having one is not associated with having another #Kidneywk
Mycotic infections are common in people with DM. Not a reason for stopping these drugs. #Kidneywk
The initial drop in GFR is not AKI and it is 100% reversible and has no prognostic significance. #kidneywk
Patients with GFR <30 may also have benefits from using these drugs with no increase of adverse events. #KidneyWk
What to do during first assessment after initiating #SGLT2i and more wisdom from trials + sick day rules. Continue the drug until the patient reaches RRT!!! #Kidneywk
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