PROJECT SUMMARY | Candidate: The candidate is an Instructor of Medicine (Nephrology) with 3 years of ongoing training in clinical research in acute kidney injury (AKI) and clinical trial design and conduct under the mentorship of the director of Yale’s Clinical and Translational Research Accelerator, a leading expert in clinical trials and pharmaco-epidemiology in AKI. This award will also allow her to receive mentorship from renowned experts in heart failure translational research, renal physiology and biostatistics to eventually become an independent clinical researcher in cardiorenal syndromes. Proposed Study: More than 1/3rd of patients hospitalized with acute heart failure (AHF) develop AKI, which is an independent risk factor for cardiovascular and kidney disease progression and mortality. AKI in this setting, often known as acute cardiorenal syndrome (CRS), is a cycle of venous congestion and overactive sodium reabsorption mechanisms characterized by diuretic resistance leading to prolonged patient distress and interruptions of essential HF therapy. The long-term goal of this study is to assess the efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) for acute CRS. SGLT2i are oral anti-hyperglycemic drugs which target a key sodium and glucose reabsorption mechanism in the kidney that have consistently slowed long-term kidney and cardiovascular disease progression in randomized clinical trials, independent of patients’ diabetes status or heart failure type. There is also pre-clinical evidence supporting their kidney tubular and endothelial protective and reparative effects in AKI. However, the efficacy and safety of SGLT2i in humans with acute CRS is unknown and AKI in this setting is a frequent reason for discontinuation. In a multicenter cohort study, we have shown that SGLT2 inhibition during AHF-associated AKI is not associated with prolonged AKI. By inhibiting an energy- demanding sodium reabsorption mechanism in the kidney’s proximal tubule, SG