Preventing Kidney Injury in Adults with Acute Heart Failure and Kidney Problems Comparing Saline Hydration and Furosemide Decongestion Strategies

What this Trial Is About

The K-PROSE study is a randomized clinical trial investigating ways to prevent contrast-induced acute kidney injury CI-AKI in patients hospitalized with acute heart failure and moderate kidney dysfunction. This research compares two strategies for kidney protection during contrast-enhanced CT imaging, focusing on whether a decongestion approach offers better renal protection than standard hydration. The study also evaluates safety and congestion outcomes in this high-risk group. Participants are randomly assigned to receive either standard intravenous saline hydration or a furosemide-based decongestion treatment before and after contrast exposure. The saline group receives 0.9% normal saline at 1 mlkg, while the decongestion group receives intravenous furosemide to promote sufficient urine output. These treatments reflect current clinical practices and aim to assess their effects on kidney function and heart failure congestion. Throughout the study, participants undergo serial blood tests to measure kidney function using creatinine, cystatin C, and other kidney injury markers. Researchers also monitor volume status and heart failure severity through body weight, urine output, physical exams, chest X-rays, and blood markers. Safety is tracked by checking for electrolyte imbalances, low blood pressure, worsening heart failure, and other adverse events. The main outcome is the incidence of acute kidney injury within 48 hours after contrast exposure, with follow-up assessments up to 90 days.

Contrast-Induced Acute Kidney Injury Prevention in Acute Heart Failure