Sodium-Glucose Cotransporter-2 Inhibitor for Patients With Acute Cardiorenal Syndrome

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Male or female, aged ≥ 18 and ≤ 85 years-old * Diagnosed with heart failure of either preserved or reduced left ventricular function * Have signs of heart failure exacerbation * Ability to take an oral medication * Willing to adhere to the SGLT2i vs placebo regimen Exclusion Criteria: * AKI can be primarily explained by another etiology * Current use of SGLT2 inhibitor or exposure in the past 72 hours * Pregnancy or lactation (pregnancy test prior to enrollment in women of child-bearing age) * Known allergic reactions to components of an SGLT2 inhibitor * Treatment with another investigational drug for heart failure different from or in addition to usual care within the 72 hours preceding AKI * 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 preceding 6 months or 3 x in the preceding 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