Overview

Deferoxamine for the Prevention of Cardiac Surgery-Associated Acute Kidney Injury

Status:
Recruiting
Trial end date:
2025-08-01
Target enrollment:
0
Participant gender:
All
Summary
Multiple lines of evidence support a central role of iron in causing acute kidney injury (AKI), including the finding that prophylactic administration of iron chelators attenuates AKI in animal models. Patients undergoing cardiac surgery may be particularly susceptible to iron-mediated kidney injury due to the profound hemolysis that often occurs from cardiopulmonary bypass. The investigators will test in a phase 2, randomized, double-blind, placebo-controlled trial whether prophylactic administration of deferoxamine decreases the incidence of AKI following cardiac surgery.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Brigham and Women's Hospital
Collaborators:
Beth Israel Deaconess Medical Center
Massachusetts General Hospital
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Treatments:
Deferoxamine
Criteria
Inclusion Criteria:

1. Age ≥18 years

2. Undergoing coronary artery bypass graft and/or valve surgery with cardiopulmonary
bypass

3. AKI risk score ≥6 at the time of screening

4. Written informed consent from the patient or surrogate

Exclusion Criteria:

1. AKI, defined as any of the following:

- Increase in serum creatinine ≥0.3 mg/dl in 48h

- Increase in serum creatinine ≥50% in 7d (if no value available in last 7d, use
most recent value in last 3 months)

- Urine output ≤0.5 ml/kg/h x 6 consecutive hours (only assessed in patients with
hourly monitoring via Foley catheter)

- Receipt of renal replacement therapy (RRT) within 7d

2. Advanced chronic kidney disease (eGFR <15 ml/min/1.73m2 or end-stage kidney disease
receiving RRT)

3. Hemoglobin <8 g/dL (closest value in the prior 3 months)

4. Fever (temperature ≥38⁰C) in the last 48h

5. Suspected or confirmed bacteremia, endocarditis, or pyelonephritis

6. Pneumonia, aspiration, or bilateral pulmonary infiltrates from an infectious etiology
reported on chest x-ray or CT scan in the last 7d

7. Positive COVID-19 test within previous 3 weeks

8. Chronic iron overload (including conditions such as hemochromatosis and beta
thalassemia major) or previous iron chelation therapy (including prior participation
in DEFEAT-AKI)

9. Known hypersensitivity to deferoxamine

10. Taking prochlorperazine

11. Severe hearing loss

12. Pregnant or breastfeeding

13. Prisoner

14. Concurrent participation in another interventional research study in which the
intervention has potential interaction with deferoxamine

15. Surgery to be performed under conditions of circulatory arrest

16. Receiving extracorporeal membrane oxygenation

17. Durable ventricular assist device (VAD) prior to surgery (does not include Impella
device or intra-aortic balloon pump)

18. Any condition which, in the judgement of the investigator, might increase the risk to
the patient

19. Conflict with other research studies