Could a common diabetes drug shield hearts in kidney failure?

This study tests whether canagliflozin, a drug used for diabetes, can improve heart structure in people with advanced kidney disease (stage 4 or 5) or on dialysis. About 92 participants will receive either the drug or a placebo for 12 months, with heart changes measured by MRI. The goal is to see if the drug can reduce heart thickening, a common complication in kidney failure.