{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:40:56Z","timestamp":1780105256830,"version":"3.54.0"},"reference-count":37,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,8,20]]},"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Percutaneous transluminal angioplasty (PTA) is often complicated due to postcontrast acute kidney injury (PC-AKI) in patients diagnosed with chronic kidney disease (CKD). Hydration therapy is the cornerstone in the prevention of PC-AKI. Furosemide forced diuresis with matched hydration using the RenalGuard system enables a steady balance between diuresis and hydration. A randomised controlled trial will be performed in order to investigate whether furosemide forced diuresis with matched hydration in combination with the RenalGuard system decreases incidence of PC-AKI in patients with CKD receiving a PTA of the lower extremities. Furthermore, we will investigate whether sampling of urine biomarkers 4\u2009hours after intervention can detect PC-AKI in an earlier stage compared with the golden standard, serum creatinine 48\u201372\u2009hours postintervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A single-centre randomised controlled trial will be conducted. Patients &gt;18 years in need of a PTA of the lower extremities and diagnosed with CKD will be randomly assigned to receive either standard of care prehydration and posthydration or furosemide forced diuresis with matched hydration periprocedural using the RenalGuard system. Four hours postintervention, a urine sample will be collected of all participating patients. Serum creatinine will be sampled within 10 days prior to intervention as well as 1, 3 and 30 days postintervention. The primary endpoint is incidence of PC-AKI post-PTA. Secondary endpoint is the rise of urine biomarkers 4\u2009hours postintervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Study protocol is approved by the research ethics committee and institutional review board (reference number 16\u2009T-201 and NL59809.096.16). Study results will be disseminated by oral presentation at conferences and will be submitted to a peer-reviewed journal. It is anticipated that study results will offer a solution to contrast-induced nephropathy in patients with CKD receiving a PTA of the lower extremities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NTR6236; Pre-results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>EudraCT number<\/jats:title>\n                    <jats:p>2016-005072-10<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-021842","type":"journal-article","created":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T08:26:11Z","timestamp":1538641571000},"page":"e021842","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Prevention of postcontrast acute kidney injury after percutaneous transluminal angioplasty by inducing RenalGuard controlled furosemide forced diuresis with matched hydration: study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"8","author":[{"given":"Lars J J","family":"Bolt","sequence":"first","affiliation":[{"name":"Department of Surgery, Zuyderland Medisch Centrum Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Anton","family":"Sigterman","sequence":"additional","affiliation":[{"name":"Department of Surgery, VieCuri Medisch Centrum, Venlo, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atilla G","family":"Krasznai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zuyderland Medisch Centrum Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees-Jan J M","family":"Sikkink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zuyderland Medisch Centrum Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert-Willem H","family":"Schurink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee Hans","family":"Bouwman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zuyderland Medisch Centrum Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,4]]},"reference":[{"key":"2025120619082344000_8.9.e021842.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198901193200303"},{"key":"2025120619082344000_8.9.e021842.2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(93)90006-8"},{"key":"2025120619082344000_8.9.e021842.3","doi-asserted-by":"publisher","DOI":"10.1583\/1074-6218(1999)006<0052:AOLLAS>2.0.CO;2"},{"key":"2025120619082344000_8.9.e021842.4","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1007\/s00330-017-5246-5","article-title":"Post-contrast acute kidney injury - Part 1: definition, clinical features, incidence, role of contrast medium and risk factors : recommendations for updated ESUR contrast medium safety committee guidelines","volume":"28","author":"van der Molen","year":"2018","journal-title":"Eur Radiol"},{"key":"2025120619082344000_8.9.e021842.5","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"2025120619082344000_8.9.e021842.6","unstructured":"Palevsky PM , Curhan GC , Sheridan AM . Definition of acute kidney injury (acute renal failure)\u00a0Uptodate.com. 2014."},{"key":"2025120619082344000_8.9.e021842.7","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.ejvs.2015.08.023","article-title":"Contrast induced nephropathy and long-term renal decline after percutaneous transluminal angioplasty for symptomatic peripheral arterial disease","volume":"51","author":"Sigterman","year":"2016","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2025120619082344000_8.9.e021842.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)00150-2"},{"key":"2025120619082344000_8.9.e021842.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.17.2038"},{"key":"2025120619082344000_8.9.e021842.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530430033035"},{"key":"2025120619082344000_8.9.e021842.11","doi-asserted-by":"publisher","DOI":"10.1159\/000329236"},{"key":"2025120619082344000_8.9.e021842.12","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000016043.87291.33"},{"key":"2025120619082344000_8.9.e021842.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01745-X"},{"key":"2025120619082344000_8.9.e021842.14","doi-asserted-by":"publisher","DOI":"10.1159\/000430770"},{"key":"2025120619082344000_8.9.e021842.15","unstructured":"Calculating the cost. Interview with marion kerr. Health Serv J 2011(Suppl 1):3."},{"key":"2025120619082344000_8.9.e021842.16","doi-asserted-by":"crossref","first-page":"c29","DOI":"10.1159\/000066641","article-title":"A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity","volume":"93","author":"Trivedi","year":"2003","journal-title":"Nephron Clin Pract"},{"key":"2025120619082344000_8.9.e021842.17","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.3.329"},{"key":"2025120619082344000_8.9.e021842.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2011.08.017"},{"key":"2025120619082344000_8.9.e021842.19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.23.2765"},{"key":"2025120619082344000_8.9.e021842.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00574-9"},{"key":"2025120619082344000_8.9.e021842.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411243312104"},{"key":"2025120619082344000_8.9.e021842.22","doi-asserted-by":"publisher","DOI":"10.1159\/000187090"},{"key":"2025120619082344000_8.9.e021842.23","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1994.32"},{"key":"2025120619082344000_8.9.e021842.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.11.035"},{"key":"2025120619082344000_8.9.e021842.25","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ijcard.2016.10.028","article-title":"Prevention of post procedural acute kidney injury in the catheterization laboratory in a real-world population","volume":"226","author":"Chorin","year":"2017","journal-title":"Int J Cardiol"},{"key":"2025120619082344000_8.9.e021842.26","doi-asserted-by":"crossref","first-page":"e1658","DOI":"10.4244\/EIJV11I14A317","article-title":"RenalGuard System for the prevention of acute kidney injury in patients undergoing transcatheter aortic valve implantation","volume":"11","author":"Visconti","year":"2016","journal-title":"EuroIntervention"},{"key":"2025120619082344000_8.9.e021842.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.12.005"},{"key":"2025120619082344000_8.9.e021842.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.11.006"},{"key":"2025120619082344000_8.9.e021842.29","unstructured":"Erdbruegger U , Palevsky PM , Sheridan AM . Etiology and diagnosis of prerenal disease and acute tubular necrosis in acute kidney injury (acute renal failure).Uptodate.com. 2014."},{"key":"2025120619082344000_8.9.e021842.30","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04010907"},{"key":"2025120619082344000_8.9.e021842.31","unstructured":"Erdbruegger U , Palevsky PM , Sheridan AM . Investigational biomarkers and the evaluation of acute tubular necrosis.Uptodate.com. 2014."},{"key":"2025120619082344000_8.9.e021842.32","doi-asserted-by":"publisher","DOI":"10.1159\/000349965"},{"key":"2025120619082344000_8.9.e021842.33","doi-asserted-by":"publisher","DOI":"10.1159\/000360689"},{"key":"2025120619082344000_8.9.e021842.34","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"2025120619082344000_8.9.e021842.35","unstructured":"Federatie van Medisch Wetenschappelijke Verenigingen. Verantwoord omgaan met lichaamsmateriaal ten behoeve van wetenschappelijk onderzoek: gedragscode 2011. Rotterdam: FEDERA, 2011."},{"key":"2025120619082344000_8.9.e021842.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(02)02771-6"},{"key":"2025120619082344000_8.9.e021842.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00917-7"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-021842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T03:08:35Z","timestamp":1765076915000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-021842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2018,10,4]]},"published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1136\/bmjopen-2018-021842"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-021842","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9]]}}}