Renal Protection at a Metabolic Cost: A Systematic Review and Meta‐Analysis of Perioperative Use of Sodium–Glucose Cotransporter 2 Inhibitors

Abstract

The use of perioperative SGLT2 inhibitors poses a clinical paradox between significant renoprotection and survival advantages and a latent risk of ketoacidosis concealed by considerable heterogeneity. While metabolic monitoring is essential, current surgeries requiring more prolonged withholding may need to weigh metabolic risk against the drug's significant benefit in reducing acute kidney injury and mortality.