In a post hoc analysis of DAPA-HF, the benefit of dapagliflozin was consistent irrespective of baseline diuretic use; however, in patients on a diuretic, adverse events related to volume depletion occurred more frequently with dapagliflozin compared with placebo.24 In addition, renal adverse events were less common with dapagliflozin compared with placebo in those not on a diuretic at baseline.24 These findings underscore the need for vigilance regarding volume status and judicious adjustment of loop diuretic doses when initiating an SGLT2 inhibitor in patients with HF. The gene discussed is SLC5A2; the disease is hydrops fetalis.