The Treatment Effects of Empagliflozin on Renal Outcomes in Cardiorenal Syndrome Type 1

Inclusion criteria

• Age 18 years or more
• Hospitalized for the primary diagnosis of acute denovo or decompensated chronic heart regardless of ejection fraction
• AKI KDIGO any stage or urine NGAL ≥ 150 ng/mL
• Must be able to be enrolled into the trial ≤ 12 hours of diagnosis of AKI or elevated urine NGAL

Exclusion criteria

• Denied to participate in the study
• Cardiogenic shock or unstable hemodynamic (systolic blood pressure of at least 100 mmHg or required inotropic support within last 24 hours)
• Cardiac mechanical support (i.e. extracorporeal membrane oxygenation and intra-aortic balloon pump)
• Acute coronary syndrome
• Diagnosed with cause of AKI other than cardiorenal syndrome (eg. sepsis, nephrotoxic, dehydration)
• Anuria or requiring dialysis or expected to required dialysis within 24 hr
• Baseline eGFR ≤ 20 ml/min/1.73m2 with or without dialysis initiated
• Heart or kidney transplanted
• Previously received any SGLT2i in the last 3 months before admission
• Allergic to any SGLT2i
• Type 1 diabetes mellitus
• History of ketoacidosis, including diabetic ketoacidosis
• Pregnancy
• Comorbid conditions with an expected survival of less than 1 months such as end-stage liver or heart disease, or uncurable malignancy