{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:23:08Z","timestamp":1793290988648,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"The Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","award":["10140022010003"],"award-info":[{"award-number":["10140022010003"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,3]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) is a major complication after cardiac surgery and is associated with postoperative morbidity and mortality. Currently, no effective therapy exists to reduce the incidence of postoperative AKI. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are effective in reducing AKI in outpatient settings for patients with chronic kidney disease. We hypothesised that perioperative SGLT2 inhibition will also reduce AKI incidence after cardiac surgery according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We designed a multicentre, randomised, placebo-controlled, triple-blinded, superiority trial. A total of 784 patients, aged above 18 years, undergoing cardiac surgery will be included with stratification for sex and type 2 diabetes in a 1:1 ratio. Patients will receive either dapagliflozin 10\u2009mg or placebo from the day before until 2\u2009days after surgery. Serum creatinine will be measured preoperatively and daily for the first 7\u2009days after the operation, and urine output will be measured until the urinary catheter is removed. The primary outcome is the incidence of postoperative AKI according to the KDIGO criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The medical ethics committee of the Amsterdam University Medical Centre (UMC) and the Dutch competent authority approved the study protocol (currently, version 9, 19 January 2024). This is an investigator-initiated study. The Amsterdam UMC, as sponsor, retains ownership of all data and publication rights. After completion of the trial, results will be disseminated to participants, patient societies and physicians via a network meeting and digital newsletter. Results will be submitted for publication in a peer-reviewed international medical journal and presented on (inter)national congresses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Clinicaltrials.gov identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05590143\">NCT05590143<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-095504","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T10:10:20Z","timestamp":1747390220000},"page":"e095504","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Study protocol of the multicentre, randomised, triple-blind, placebo-controlled MERCURI-2 trial: promoting effective renoprotection in cardiac surgery patients by inhibition of sodium glucose cotransporter (SGLT)-2"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct05590143","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05590143","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2906-2518","authenticated-orcid":false,"given":"Maartina","family":"Oosterom-Eijmael","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands"},{"name":"Department of Endocrinology, Amsterdam University Medical Center, Amsterdam, The Netherlands"},{"name":"Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson P","family":"Monteiro de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Medisch Spectrum Twente, Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed D","family":"Niesten","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Medisch Spectrum Twente, Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Tolsma","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Isala Clinics, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand TF","family":"Snellen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Isala Clinics, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas M","family":"Gerritse","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Amphia Ziekenhuis, Breda, North Brabant, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry V","family":"Scohy","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Amphia Ziekenhuis, Breda, North Brabant, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5634-9672","authenticated-orcid":false,"given":"T","family":"Rettig","sequence":"additional","affiliation":[{"name":"Anesthesiology, Intensive Care and Pain Medicine, Amphia Hospital site Molengracht, Breda, Noord-Brabant, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M B","family":"Godfried","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Noord-Holland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magiel F","family":"Voogd","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, 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