| Title: |
Preventing kidney injury using carbon dioxide (KID trial): trial protocol for a multicentre randomised controlled trial |
| Authors: |
Saratzis, Athanasios; Rasheed, Neha; Aguirre, Dania; Coughlin, Patrick; Diamantopoulos, Athanasios; Bearne, Lindsay; Selby, Nicholas M.; Brookes, Cassandra; Barber, Shaun; Richardson, Carla; Gilbert, Hannah; Schueller, Roland; Apergi, Despina; Harris, Keith Jonathan |
| Publisher Information: |
BMJ Publishing Group |
| Publication Year: |
2025 |
| Collection: |
University of Nottingham: Repository@Nottingham |
| Description: |
INTRODUCTION: Peripheral arterial disease (PAD) commonly coexists with chronic kidney disease (CKD). Patients with symptomatic PAD often require endovascular revascularisation to relieve pain or salvage limbs. However, the iodinated intra-arterial contrast routinely used in these procedures is nephrotoxic, placing patients with CKD at increased risk of acute kidney injury (AKI) and long-term renal decline. Carbon dioxide (CO₂) delivered via automated injection is a potential alternative imaging contrast medium. This trial will evaluate whether using CO₂ instead of iodinated contrast reduces the risk of AKI and short-term renal function decline in this high-risk group. METHODS AND ANALYSIS: This is a multicentre, open-label, prospective randomised controlled trial across six secondary-care National Health Service (NHS) vascular surgery centres. A total of 174 patients with PAD and CKD undergoing endovascular intervention will be randomised 1:1 to receive iodinated contrast (standard of care) or CO₂ via automated injector (Angiodroid). All perioperative care will follow local NHS protocols.The primary outcome is log serum creatinine at 2, 30 and 90 days postprocedure. Key secondary outcomes include: incidence and severity of AKI within 48 hours postprocedure, major adverse kidney events (death, dialysis or >25% estimated glomerular filtration rate decline) by 90 days, inpatient length of stay, procedural pain, quality of life, procedural success, reinterventions, acceptability and feasibility (patient/practitioner questionnaires) of using CO2, and cost-effectiveness (healthcare resource use analysis). A mixed-methods process evaluation will be undertaken with patients and clinicians. ETHICS AND DISSEMINATION: The trial has been approved by an NHS ethical review committee (24/WA/0332) and patients have been involved in trial design. Findings will be disseminated to participants, clinicians and the wider public through patient groups, lay summaries, social media, conferences, peer-reviewed journals and NHS policy ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://nottingham-repository.worktribe.com/output/57286841; BMJ Open; Volume 15; Issue 11 |
| DOI: |
10.1136/bmjopen-2025-111752 |
| Availability: |
https://doi.org/10.1136/bmjopen-2025-111752; https://nottingham-repository.worktribe.com/file/57286841/1/e111752.full; https://nottingham-repository.worktribe.com/output/57286841 |
| Rights: |
openAccess ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.CF2D539F |
| Database: |
BASE |