Preventing contrast-related kidney injury in people hospitalized with acute heart failure
Contrast-Induced Acute Kidney Injury in Acute Heart Failure With Renal Dysfunction: The Kidney Protection Strategies Evaluation in Acute Heart Failure (K-PROSE)
This study tests whether a furosemide-based decongestion approach works better than standard IV saline to protect the kidneys of adults hospitalized with acute heart failure and moderate kidney dysfunction who need contrast scans.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 190 (estimated) |
| Ages | 20 Years and up |
| Sex | All |
| Sponsor | Seoul National University Bundang Hospital Academic / other |
| Locations | 1 site (Seongnam-si, Gyeonggi-do) |
| Trial ID | NCT07550790 on ClinicalTrials.gov |
What this trial studies
The K-PROSE study enrolls adults hospitalized with acute heart failure, clinical evidence of congestion, and baseline eGFR 30–75 mL/min/1.73 m² who require contrast-enhanced CT imaging. Participants are randomized to receive either standard intravenous isotonic saline hydration or a furosemide-based decongestion protocol before and after contrast exposure. Renal function is monitored with serial measurements of serum creatinine, eGFR, and cystatin C, and outcomes include incidence of contrast-induced acute kidney injury, changes in congestion status, and safety events. The trial is designed to reflect real-world acute care while systematically comparing renal and clinical outcomes between the two strategies.
Who should consider this trial
Good fit: Adults aged 20 or older hospitalized for acute heart failure with clinical congestion, baseline eGFR 30–75 mL/min/1.73 m², and a planned contrast-enhanced CT during the admission are the intended participants.
Not a fit: Patients requiring vasopressors or renal replacement therapy, those with active acute coronary syndrome, severe electrolyte disturbances or volume depletion, pregnant or breastfeeding women, or anyone with a furosemide allergy would not be expected to benefit or be eligible.
Why it matters
Potential benefit: If successful, this approach could reduce contrast-induced kidney injury and its complications in high-risk acute heart failure patients, potentially lowering the need for dialysis and shortening hospital stays.
How similar studies have performed: While IV saline hydration has been shown to reduce CI-AKI risk in broader populations, applying a furosemide-based decongestion strategy specifically in acute heart failure is relatively novel and supported by limited prior data.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults aged 20 years or older * Emergency department visit/hospitalization for acute heart failure with clinical evidence of congestion * Planned contrast-enhanced computed tomography during the index hospitalization * Baseline renal dysfunction defined as an estimated glomerular filtration rate (eGFR) of 30-75 mL/min/1.73 m² Exclusion Criteria: * Requirement for vasopressor therapy * Requirement for renal replacement therapy (dialysis) * Known allergy or hypersensitivity to furosemide * Ongoing acute coronary syndrome * Pregnant or breastfeeding women, or women of childbearing potential without a negative pregnancy test * Hyperkalemia (serum potassium \>5.5 mmol/L) * Uncorrected volume depletion or hyponatremia (serum sodium \<130 mmol/L) * Any condition deemed by the investigator to make participation in the study inappropriate
Where this trial is running
Seongnam-si, Gyeonggi-do
- Seoul National University Bundang Hospital — Seongnam-si, Gyeonggi-do, South Korea (Recruiting)
Study contacts
- Principal investigator: Jin Joo Park, MD, PhD — Seoul National University Bundang Hospital
- Study coordinator: Jin Joo Park, MD, PhD
- Email: jinjooparkmd@snubh.org
- Phone: +82-031-787-8800
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.