Up to 50% of patients undergoing cardiac surgery may experience acute kidney injury (AKI). However, measures to prevent AKI are “largely lacking,” according to Maartina Oosterom-Eijmael, MD, and colleagues at Amsterdam UMC Locatie AMC, the Netherlands. Results of previous trials, in which kidney and cardiovascular outcomes were evaluated, have suggested an association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and lower incidence of AKI (hazard ratio, 0.66; 95% CI, 0.55-0.80).
During an oral session at the American Society of Nephrology Kidney Week 2025, the researchers reported results of a multicenter, triple-blinded, placebo-controlled randomized trial to test the hypothesis that perioperative treatment with dapagliflozin could reduce the incidence of postoperative AKI in patients undergoing cardiac surgery. The session was titled proMoting Effective Renoprotection in Cardiac Surgery Patients by Inhibition of SGLT2 (MERCURI-2): A Randomized Controlled Trial in People Undergoing Cardiac Surgery.
The study cohort included adult patients undergoing elective cardiac surgery. Participants were randomized to receive oral dapagliflozin (10 mg) or matching placebo once daily from the day before the surgery until the second day after the surgery. The primary outcome of interest was the difference between the two groups in the incidence of AKI as defined by Kidney Disease: Improving Global Outcomes criteria. Secondary outcomes included differences in individual stages of AKI.