Sodium-Glucose Cotransporter-2 Inhibitor for Acute Cardiorenal Syndrome: A Feasibility Study

Eligibility Criteria

• 1. Provision of signed and dated informed consent form
• 2. Stated willingness to comply with all study procedures and availability for the duration of the study
• 3. Male or female, aged ≥ 18 and ≤ 85 years-old
• 4. Diagnosed with heart failure of either preserved or reduced left ventricular function
• 5. NT-proBNP \> 300 pg/mL
• 6. Ability to take an oral medication
• 7. Willing to adhere to the SGLT2i + usual care regimen
• 1. Current use of SGLT2 inhibitor or use in the past 72 hours
• 2. Pregnancy or lactation (a pregnancy test will be performed prior to enrollment in women of child-bearing age)
• 3. Known allergic reactions to components of an SGLT2 inhibitor
• 4. Treatment with another investigational drug for heart failure different from or in addition to usual care within the 72 hours preceding AKI
• 5. Any individual who meets any of the following criteria will be excluded from participation in this study:
• * Documented history of ileal conduit (neobladder)
• * No means of collecting urine such as patients with documented incontinence without indwelling or external urinary catheter
• * Advanced kidney disease at baseline defined as baseline eGFR \< 25 ml/min/1.73m2
• * Unexplained hypoglycemia in the past 30 days from enrollment
• * History of Fournier's gangrene (pelvic necrotizing fasciitis)
• * History of recurrent urinary tract infection (UTI): defined as documented UTI at least 2x in the past 6 months or 3 x in the past 12 months
• * End-stage kidney disease with dialysis requirement
• * Oliguria: defined as less than 30 ml urine output per hour for more than two consecutive hours or less than 500 ml over the preceding 24 hours
• * Severe acute kidney injury with indications for dialysis
• * Current dialysis receipt for acute kidney injury
• * Comfort measures only
• * Solid organ transplant on immunosuppression