MERCURI-2 — testing SGLT2 inhibition against acute kidney injury after cardiac surgery
A multicentre, randomised, placebo-controlled trial asking whether a short perioperative course of dapagliflozin — an SGLT2 inhibitor — reduces the incidence of acute kidney injury (AKI) after cardiac surgery.
Funded by ZonMw (Goed Gebruik Geneesmiddelen), project number 10140022010003. Registered at ClinicalTrials.gov, NCT05590143. If you took part and left your email on the consent form, we’ll contact you once the trial concludes and results are published.
The problem
Acute kidney injury is one of the most common major complications after cardiac surgery and is associated with significant postoperative morbidity and mortality. No effective therapy currently exists to reduce its incidence. SGLT2 inhibitors have shown renoprotective signals in other populations independent of their glucose-lowering effect, so we hypothesise that perioperative SGLT2 inhibition will reduce the incidence of AKI after cardiac surgery.
Design
A multicentre, randomised, placebo-controlled, triple-blinded superiority trial. We aim to include 784 patients undergoing cardiac surgery, aged 18–90, randomised 1:1 and stratified by sex and type 2 diabetes status. Participants receive either dapagliflozin 10mg or placebo from the day before surgery until two days after. The primary outcome is the incidence of acute kidney injury according to the KDIGO (Kidney Disease: Improving Global Outcomes) criteria.
Progress
Enrolment completed on 27 January 2025, with all 784 participants randomised across the trial’s seven centres. Final follow-up was completed on 16 May 2025. The trial data are now being analysed and the manuscript is being prepared for submission. Results will be added here once published.
Participating centres
Amsterdam UMC
Amsterdam, the Netherlands
Tahira El Benhaji, Catherine S. C. Bouman, Naomi Chen, Thomas G. V. Cherpanath, Giel Cox, Marcel G. Dijkgraaf, Nimrat Grewal, Hilde Herrema, Nathalie J. Huizing, Robert J. M. Klautz, Lars G. Knaap, Wil G. Kopatz, Marcella C. A. Müller, Abigail J. Murray, Frederique Paulus, Gabriela L. Pieters, Jorinde A. W. Polderman, Merlijn Reijrink, Abby Roest, Cato Schmitz, Youri Schut, Lars I. P. Snel, Nick G. Steijn, Ayla Y. Stobbe, Hajar Taârnit, Luuk T. Tegel, Divya P. R. Tika, Imran Uddin, Denise P. Veelo, Alexander P. J. Vlaar
OLVG
Amsterdam, the Netherlands
Leiden University Medical Center
Leiden, the Netherlands
Eline F. Bruggemans
Amphia Hospital
Breda, the Netherlands
Maaike S. Y. Thio, Michelle Verhagen
Medisch Centrum Leeuwarden
Leeuwarden, the Netherlands
Isala
Zwolle, the Netherlands
Yvonne J. Jordens, Alice C. Pap, Martijn Tolsma, Henrico J. F. T. Wesselink
Medisch Spectrum Twente
Enschede, the Netherlands
The MERCURI-2 Study Group also gratefully acknowledges the contribution of Nardo J. van der Meer (Catharina Hospitals, Eindhoven).
Associated organisations
ZonMw
Where this leads
MERCURI-2 is the confirmatory trial that followed the MERCURI-1 pilot, and its own ZonMw GGG grant sits alongside the separate GGG grants that fund GUIDE on the glucose-control line and MERCURI-3 on this line. MERCURI-3 takes the question further, asking whether patients already on an SGLT2 inhibitor should continue it through surgery rather than start one beforehand. Its urinary-oxygenation sub-study also feeds directly into NEPTUNE.