The potential of GLP-1 RAs to prevent incident HF and progression to ESKD is of paramount importance, as increasing evidence suggests that patients with MGUS are at higher risk of developing HF and kidney failure compared with the non-MGUS population.12,34 One potential mechanism involves paraprotein deposition in myocardial and renal tissues, manifesting monoclonal gammopathy of CV and renal significance. The gene discussed is GLP1R; the disease is hydrops fetalis.