{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:35:11Z","timestamp":1780104911776,"version":"3.54.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,9,13]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>The RenalGuard System, which creates high urine output and fluid balancing, may be beneficial in preventing contrast-induced acute kidney injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      The Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II) trial is a randomized, multicenter, investigator-driven trial addressing the prevention of contrast-induced acute kidney injury in high-risk patients. Patients with an estimated glomerular filtration rate \u226430 mL \u00b7 min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7 1.73 m\n                      <jats:sup>\u22122<\/jats:sup>\n                      and\/or a risk score \u226511 were randomly assigned to sodium bicarbonate solution and N-acetylcysteine (control group) or hydration with saline and N-acetylcysteine controlled by the RenalGuard System and furosemide (RenalGuard group). The primary end point was an increase of \u22650.3 mg\/dL in the serum creatinine concentration at 48 hours after the procedure. The secondary end points included serum cystatin C kinetics and rate of in-hospital dialysis. Contrast-induced acute kidney injury occurred in 16 of 146 patients in the RenalGuard group (11%) and in 30 of 146 patients in the control group (20.5%; odds ratio, 0.47; 95% confidence interval, 0.24 to 0.92). There were 142 patients (48.5%) with an estimated glomerular filtration rate \u226430 mL \u00b7 min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7 1.73 and 149 patients (51.5%) with only a risk score \u226511. Subgroup analysis according to inclusion criteria showed a similarly lower risk of adverse events (estimated glomerular filtration rate \u226430 mL \u00b7 min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7 1.73 m\n                      <jats:sup>\u22122<\/jats:sup>\n                      : odds ratio, 0.44; risk score \u226511: odds ratio, 0.45;\n                      <jats:italic>P<\/jats:italic>\n                      for interaction=0.97). Changes in cystatin C at 24 hours (0.02\u00b10.32 versus \u22120.08\u00b10.26;\n                      <jats:italic>P<\/jats:italic>\n                      =0.002) and 48 hours (0.12\u00b10.42 versus 0.03\u00b10.31;\n                      <jats:italic>P<\/jats:italic>\n                      =0.001) and the rate of in-hospital dialysis (4.1% versus 0.7%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.056) were higher in the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion\u2014<\/jats:title>\n                    <jats:p>RenalGuard therapy is superior to sodium bicarbonate and N-acetylcysteine in preventing contrast-induced acute kidney injury in high-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrial.gov.\">http:\/\/www.clinicaltrial.gov<\/jats:ext-link>\n                      . Unique identifier: NCT01098032.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.111.030759","type":"journal-article","created":{"date-parts":[[2011,8,16]],"date-time":"2011-08-16T00:48:27Z","timestamp":1313455707000},"page":"1260-1269","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":206,"title":["Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II)"],"prefix":"10.1161","volume":"124","author":[{"given":"Carlo","family":"Briguori","sequence":"first","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Visconti","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Focaccio","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Airoldi","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Valgimigli","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Massimo","family":"Sangiorgi","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Golia","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Ricciardelli","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerolama","family":"Condorelli","sequence":"additional","affiliation":[{"name":"From the Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples (C.B., G.V., A.F., B.G., B.R.); Laboratory of Interventional Cardiology IRCCS Multimedica, Milan (F.A.); Cardiovascular Research Centre, University of Ferrara, Ferrara (M.V.); Division of Cardiology, University of Modena-Reggio Emilia, Modena (G.M.S.); and Department of Cellular and Molecular Biology and Pathology, \u201cFederico II\u201d University of Naples (G.C.), Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the REMEDIAL II Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.12.035"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00550109"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.919639"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-10-38"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.9.1038"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.01.035"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.19.2328"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.687152"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00574-9"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-4717-4_42"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411243312104"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000187090"},{"key":"e_1_3_2_14_2","first-page":"A36","article-title":"Prevention of contrast induced nephropathy using high volume matched diuresis using the RenalGuard System: first-in-man study [abstract]","volume":"53","author":"Resnic FS","year":"2009","unstructured":"Resnic FS, Davidson C, Zelman R, Dixon SR, Rudko R, Dorval JF. 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