SLC5A2 and hydrops fetalis: Other proposed derived mechanisms of SGLT2 inhibitors supporting beneficial cardiovascular effects in HF patients include a favorable shift in glucose and fat metabolism towards increased ketone substrate use [18, 19], renoprotective effects with changes in intrarenal hemodynamics, uricosuria and reduced albuminuria [7], and direct cardiac effects with remodeling of the myocardium ultimately leading to an improvement in the ventricular systolic function [9].