Contrast-Induced Acute Kidney Injury in Acute Heart Failure With Renal Dysfunction: The Kidney Protection Strategies Evaluation in Acute Heart Failure (K-PROSE)

What this Trial Is About

Researchers are investigating ways to prevent contrast-induced acute kidney injury (CI-AKI) in patients hospitalized with acute heart failure and moderate kidney dysfunction defined by an estimated glomerular filtration rate (eGFR) between 30 and 75 mL/min/1.73 m². This study compares standard intravenous saline hydration to a furosemide-based decongestion strategy in patients who require contrast-enhanced computed tomography. The goal is to determine which approach better protects kidney function without worsening congestion in this vulnerable group. Participants are randomly assigned to one of two treatment strategies before and after receiving contrast imaging. One group receives standard intravenous hydration with normal saline dosed at 1 mL/kg, while the other group receives intravenous furosemide aimed at producing significant diuresis of at least 1,000 mL to reduce fluid overload. These treatments reflect current clinical practices and are designed to evaluate direct effects on kidney protection and congestion management. Throughout the study, kidney function is closely monitored using blood markers like creatinine and cystatin C before and 48 hours after contrast exposure. Additional assessments include urine chemistry, body weight, urine output, physical exams, chest x-rays, and natriuretic peptide levels to track volume status and heart failure severity. Safety is evaluated by monitoring for electrolyte imbalances, worsening heart failure, and other adverse events. The study will also record longer-term outcomes such as hospital stay length, ICU admissions, and mortality up to 90 days after enrollment.

Contrast-Induced Acute Kidney Injury Prevention in Acute Heart Failure