Appendix 1:

Inclusion Criteria to Accompany Supplementary Table 3

NCT	Inclusion criteria
NCT02698930	patients with infective endocarditis patients who are scheduled to undergo open heart surgery
NCT02607163	the patients undergoing ascending, arch and/or proximal descending aorta surgery with cardiopulmonary bypass 20 - 100 yrs. old
NCT02875873	Need for plasma expansion, and the clinician considers that Plasma-Lyte® or 0.9% saline are equally appropriate for patients, with no specific indications or contraindications for any of the fluids or for rapid or slow infusion. Patients not expected to be discharged on the day after their admission. At least one of the following risk factors for acute renal injury: Age ≥ 65 years Hypotension (mean arterial pressure [MAP] < 65 mmHg or systolic blood pressure [SBP] < 90 mmHg) or use of vasopressors Sepsis Use of invasive mechanical ventilation or of continuous noninvasive mechanical ventilation (including high-flow nasal cannula) > 12 hours Oliguria (< 0.5 mL/kg/hour for ≥ 3 hours) Serum creatinine ≥ 1.2 mg/dL for women or ≥ 1.4 mg/dL for men Liver cirrhosis or acute liver failure
NCT03277677	Age ≥ 18 years old Who need fluid resuscitation in the Emergency Room (ER) Who have fulfilled the criteria for sepsis/septic shock within the previous 24 hours according to sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection Patients with infection and resulted from a hosťs systemic inflammatory response syndrome (SIRS) to infection are defined as sepsis if meet the criteria 2 or more of Temperature >38°C or <36°C Heart rate >90/min Respiratory rate >20/min or PaCo2 <32 mm Hg (4.3 kPa) White blood cell count >12000/mm3 or <4000/mm3 or >10% immature bands. Patient who have Septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Patients with septic shock can be identified with a clinical construct of sepsis with persisting hypotension requiring vasopressors to maintain MAP ≥65 mm Hg and having a serum lactate level >2 mmol/L (18 mg/dL) despite adequate volume resuscitation. AND where informed consent is obtainable either from the patient or by proxy (first degree relative, spouse) if patients arenť in fully conscious status (e.g. comatose, drowsiness, irritable).
NCT03188614	Shock patients
NCT02980003	Consecutive patients scheduled for coronary angiography and/or angioplasty; eGFR <60 mL/min/1.73 m2, but >15 mL/min/1.73 m2 (MDRD formula).
NCT02799368	Individuals aged 18 years or older with eGFR < 45 mL/min/1.73m2 or eGFR < 60 mL/min/1.73m2 who have at least one condition Diabetes mellitus Age > 60 year Able and willing to provide informed consent
NCT02793661	Age > 18 years old 15 ml/min/m2 ≤ eGFR ≤ 40 ml/min/m2 High volume contrast-requiring cardiovascular procedures (estimated contrast volume > 3 times eGFR value) Patient has agreed to all FU testing
NCT02974946	Patients undergoing surgery (elective or in-house urgent) Patient 18 years old and over Patient able to give written consent Patient at risk of developing AKI after cardiac surgery (at least one factor) Diabetics (IDDM or NIDDM) with normal kidney function pre-op Patients with eGFR 20-60 Patients undergoing combined cardiac procedures when the CPB time is likely to exceed 120 minutes Patients with Hb of 12.5 g/dl or below Logistic Euroscore of 5 and above Patient not involved with another study
NCT01866800	Subject is 65 years old who is able and willing to give an informed consent. Patients undergoing planned trans-femoral TAVI. Calculated eGFR below 60ml/min/1.73m2 (MDRD)
NCT03509935	Age equal or superior to 18 years. Major surgeries requiring ICU admission associated with one of the following criteria: Use of vasoactive drugs Use of inotropic drugs Mean blood pressure less than 65 mmHg or SBP <90 mmHg. Hyperlactatemia> 2 mmol / L Heart rate> 90 bpm. Invasive mechanical ventilation required for at least 6 hours at the time of inclusion. Hypoxia: satO2 <92% in ambient air. Length of surgery greater than 4 hours. Request for transfusion of blood products in a surgical block Oliguria during procedure, defined as diuresis <0.5 ml/kg/h.
NCT02481518	Age > 18 years Eastern Cooperative Oncology Group score 0-2 First Diagnosed Head and neck cancer and plan for treatment with cisplatin Serum creatinine ≤1.5 mg/dl or eGFR≥60(ml/min/1.73 m2)
NCT03056248	A male or female greater than 18 years Stable renal function with creatinine change <0.3mg/dl in the preceding 1 month prior to scheduled surgery Procedure such as aortic valve surgery, mitral valve surgery, coronary artery bypass grafting, or combination of the above mentioned procedures Have estimated glomerular filtration rate greater than or equal to 15ml/min/ 1.73m2 as calculated by chronic kidney disease Epidemiology Collaboration (CKD-EPI) formula
NCT03331146	Patients CCFS score ≥ 6 Patients admitted to UAB cardiac intensive care unit (CICU) following elective cardiac surgery with cardiopulmonary bypass under general endotracheal anesthesia 19 years old Estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m2
NCT03476460	Patients >65 years, Both sexes, With at least one of the following criteria: diabetes or stable heart failure or chronic kidney disease (estimated glomerular filtration rate between 30 and 60 ml/min), Undergoing CT scan with contrast Written informed consent.
NCT03396770	On-pump cardiac surgery; Informed and written consent of the patient or inclusion according to the emergency procedure; Affiliated patient or beneficiary of a social protection
NCT02531412	Patients admitted to the ICU in the immediate postoperative period (first 24 hours) of major surgery, defined as involving general anesthesia, ventilation, opening of large cavities (cranial, thoracic, abdominal). Patients with informed consent signed by them or their responsible relative. Patients who are likely to survive at least 48 hours after admission to the ICU. Patients who have measured "baseline" creatinine before UCI admission, in the last three months.
NCT03206658	Patients older than 18 years of age Patients critically ill requiring invasive mechanical ventilation with some organic failure in addition to respiratory failure. Organic scale failure will be categorized according to the (Sequential Organ Failure Assessment) scale and will be considered present when there is a score ≥2 in some organ / system, except renal. Patients with normal renal function or chronic kidney disease KDOQI 1-3 Patients without acute renal injury according to the (acute kidney injury network) AKIN criteria. Normal serum K levels (less than or equal to 5 mEq / L). Women with (a) negative pregnancy test, (b) surgical sterilization, or (c) completed menopause. Systolic blood pressure> 90 mmHg and mean arterial pressure> 70 mmHg. Diuresis in the first 6 hrs. from admission to intensive therapy> 0.5 ml / kg / hr. The patient will give written and signed informed consent prior to any specific study procedure. However, if a patient cannot do so before, his or her legal representative the Institute may give written informed consent.
NCT03329443	patients admitted to angiography unit over 18 informed consent
NCT01275729	18 yrs. or older increase in serum creatinine of 0.3 mg/dl within 48 hours or an increase of greater than or equal to 150% from baseline or sustained oliguria (UOP < 0.5 cc/kg/hr. for 6 hours with the last 48hours) written informed consent patients with an indwelling bladder catheter
NCT02983422	Patients with acute injury (AKI) with no lack of circulating volume (central venous pressure >8cmH2O)
NCT02771509	Patient is either male or female ≥ 18 years. Patient has provided written informed consent, and is willing and able to comply with the requirements of the study protocol, including screening procedures. Patient must be scheduled for and undergo a non-emergent cardiac surgical procedure involving CPB. Eligible procedures include: Coronary artery bypass graft (CABG) alone Aortic valve replacement or repair alone, with or without aortic root repair Mitral, tricuspid, or pulmonic valve replacement or repair alone Combined replacement of several cardiac valves CABG with aortic, mitral, tricuspid, or pulmonic valve replacement or repair CABG with combined cardiac valve replacement or repair. Patient must have the following risk factor(s) for AKI prior to surgery: Estimated glomerular filtration rate (eGFR) of ≥ 20 and < 30 ml/min/1.73m2, or eGFR ≥ 30 and < 60 mL/min/1.73m2 and ONE of the following Additional Risk Factors (other than age ≥ 75 years), or eGFR ≥ 60 ml/min/1.73m2 and TWO of the following Additional Risk Factors eGFR will be calculated using the abbreviated MDRD equation (MDRD-4, often referred to as the Levey equation): eGFR = 186.3 x sCr-1.154 x Age-0.203 x [0.742 if Female] x [1.212 if Black] Additional Risk Factors: Combined valve and coronary surgery Previous cardiac surgery with sternotomy Left ventricular ejection fraction (LVEF) < 35% by invasive or noninvasive diagnostic cardiac imaging within 90 days prior to surgery Diabetes mellitus requiring insulin treatment Non-insulin-requiring diabetes with documented presence of at least moderate (+2) proteinuria on urine analysis (medical history or dipstick) Documented NYHA Class III or IV within 1 year prior to index surgery Age ≥ 75 years can be considered an Additional Risk Factor only for patients with eGFR ≥ 60 ml/min/1.73m2. Patient must have presented for surgery without prior evidence of active renal injury defined as no acute rise in sCr > 0.3 mg/dL or no 50% increase in sCr between the time of Screening and pre-surgery. Patienťs body mass index (BMI) < 35 at Screening. Female patients of childbearing potential (including perimenopausal women who have had a menstrual period within 1 year): Must have a negative serum pregnancy test prior to surgery. Must agree (1) to use 2 forms of effective birth control regimen (at least one-barrier method) during the 90-day study period or (2) to maintain total abstinence throughout the 90-day study period. Male patients must agree to use condoms or other suitable means of pregnancy prevention such as abstinence during the 90-day study period.
NCT02474667	All patients must provide written informed consent using an Institutional Review Board/Independent Ethics Committee (IRB/IEC) approved consent form, and must understand and be willing and able to comply with the requirements of the study, including screening procedures and all required study visits. Males and females ≥ 18 years of age. Oligoanuric renal failure (less than 200 mL of UO per day) requiring hemodialysis or peritoneal dialysis initiated at least 3 months prior to transplantation. Patient is to be the recipient of a first kidney transplant from a deceased donor. Study drug can be administered starting within 30 hours after restoration of blood flow to the engrafted kidney. Body mass index < 35 based on dry weight. Dry weight and height parameters obtained within 7 days prior to study entry may be used. Estimated donor organ cold ischemia time less than 30 hours (for PMP kidneys less than 40 hours). Females of childbearing potential (including perimenopausal women who have had a menstrual period within 1 year): Must have a negative serum pregnancy test prior to transplantation. Must agree to use 2 forms of effective birth control regimen (at least one-barrier method) during the initial 30-day study period OR agree to maintain total abstinence throughout the initial 30-day study period. Male patients must agree to use condoms or other suitable means of pregnancy prevention such as abstinence during the initial 30-day study period. Patient has poor renal function in the first 24 hours post-transplantation based on an average UO of less than 50 mL per hour over any 8 consecutive hours, to maximize the likelihood that the patient requires dialysis within the first 7 days post-transplant, irrespective of pre-transplant donor and recipient risk factors. Reason for low UO is not due to structural or vascular abnormalities which, when indicated should be confirmed with a renal ultrasound with Doppler study and/or vascular or urinary tract contrast studies.
NCT02808351	Planned diagnostic coronary or peripheral artery angiography Type 2 diabetes mellitus CKD stages ≥2 Statin naive, or not on statin treatment for at least 14 days Withdrawal metformin or aminophylline for 48h before angiography Total iodixanol volume
NCT02869347	Estimated glomerular filtration rate (eGFR) of <50 ml/min/1.73m2 At least one of the following risk factors: diabetes mellitus, age at least 75 years, anemia (baseline hematocrit value less or equal 39% for men and less or equal 36% for women), congestive heart failure class III or IV by New York Heart Association classification, history of pulmonary edema.
NCT02962102	Age ≥ 18 Admitted to the ICU within 48h prior to enrollment Likely to remain in the ICU (alive) for ≥72h Naso/orogastric tube or ability to swallow High risk of severe AKI
NCT03401710	All adult patients > 18 years old hospitalized with acute kidney injury and anemia
NCT03007537	Preoperative hemoglobin＜130g/L; Surgery: valve, coronary artery bypass graft or surgery for congenital heart diseases; Volunteers with informed consent.
NCT02665377	De novo Htx. Preoperative GFR > 30ml/min/1,73m2. >18 years old. Written consent.
NCT02836899	Provide written informed consent Age ≥ 18 years of age Elective cardiac or aortic surgery with CPB>90 minutes Stable pre-operative renal function without evidence of plasma creatinine level increase of ≥ 0.3 mg/dL over the prior 3 months and without renal replacement therapy (RRT). Clinical evidence of endothelial dysfunction assessed by a specifically designed questionnaire.
NCT02664753	The emergency inclusion procedure was correctly applied according to French law (signature of consent form by a patient-designated trusted person or a family member, or a medical decision to proceed with patient inclusion if the latter two persons are unavailable) ---- OR ---- signature of the consent form by the patient The patient must be insured or beneficiary of a health insurance plan The patient is at least 18 years old The patient has been admitted to a participating ICU for severe sepsis or septic shock within the last 72 hours The patient has sepsis or septic shock according to international criteria SEPSIS 3 (Singer et al, The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3); JAMA 2016). The patient has acute renal insufficiency with an KDIGO score of 3 The patient has started continuous renal replacement therapy (CRRT) or intermittent renal replacement therapy (IRRT) within the past 24 hours, or will start RRT (CRRT or IRRT) within the next 24 hours
NCT02531724	Patients in the cardiothoracic intensive care after cardiac surgery with cardiopulmonary bypass Acute kidney injury, defined as increase in S-creatinine 50% or 27 mol/L Normal S-creatinine before surgery
NCT01720030	Clinically diagnosed adult patients with AKI
NCT03510897	Male or female, age ≥ 18 years old At risk for AKI following cardiac surgery on the basis of at least one of the following pre-operatively assessed risk factors: Reduced renal function Diabetes with ongoing insulin treatment Albuminuria Undergoes non-emergent open chest cavity cardiovascular surgeries, with use of cardiopulmonary bypass (CPB), with or without hypothermic circulatory arrest
NCT03403751	Has either suspected or documented diagnosis of abdominal sepsis requiring treatment with parenteral antibiotics and planned or completed surgical (laparotomy or laparoscopy) or interventional radiologic procedures within 24 hours of evaluation by medical personnel. Recommended surgical or interventional radiologic procedures be performed with 12 hours of evaluation by medical personnel. Initial diagnosis of AKI Stage 2 or 3 according to KDIGO AKI criteria established either upon presentation to medical care in those patients with suspected abdominal sepsis or in those patients in whom the initial diagnosis of AKI is established during the 48-hour period from the suspected diagnosis of abdominal sepsis. Study medication must be administered within 6 hours of confirmation of onset of Stage 2 or 3 AKI as established at the study site, under the following criteria: After the decision is made by the attending surgeon at the study site for a surgical or interventional radiology procedure for the abdominal infection OR After confirmed diagnosis of abdominal infection has been established by a surgical or interventional radiology procedure
NCT03526367	Age 18-80 years old The STEMI patients within 12 h of onset (or within 12-24 h of onset with chest pain and persistent ST-segment elevation or the presence of a new LBBB); The patients planned primary PCI; At least one of the following:
NCT03273751	Adult patients scheduled to undergo open, laparoscopic, or robot-assisted laparoscopic partial nephrectomy Normal contralateral renal function was defined as split renal function of >40% as determined by preoperative Tc-99m DiethyleneTriamine Pentaacetic Acid (DTPA) kidney scan Written informed consent
NCT03236441	Patient with non-ST elevation myocardial infarction or unstable angina Referral for cardiac catheterization and percutaneous coronary intervention Contrast-induced acute kidney injury risk score of ≥11
NCT02997748	Patients who are scheduled to undergo cardiac surgery with cardiopulmonary bypass Cleveland Clinic Score >=6
NCT02518087	Patients with more than 18 years old. Non emergent cardiac surgery patients requiring expected CPB time > 60 minutes: double valve replacement or valve replacement plus coronary arterial bypass graft (CABG). Written informed consent from patient or legal surrogates.
NCT03384875	Scheduled for non-emergent cardiac surgery requiring CPB for i) heart valve replacement with any other procedure, without hypothermic circulatory arrest (HCA), or ii) aortic reconstruction with or without another procedure, with HCA
NCT02250131	Patients undergoing cardiac operations with CPB. Expected CPB duration > 90 minutes.
NCT03373318	Adult patients (> 18 years) scheduled for cardiopulmonary bypass surgery with Glomerular Filtration Rate (GFR) greater than or equal to 60 and left ventricular ejection fraction greater than or equal to 40%
NCT02568722	Age ≥ 18 years Admission to an intensive care unit (ICU) Evidence of kidney dysfunction [serum creatinine ≥100 µmol/L (women) and ≥ 130 µmol/L (men)] Evidence of severe AKI defined by at least 1 of the following 3 criteria: i) ≥ 2-fold increase in serum creatinine from a known pre-morbid baseline or during the current hospitalization; OR ii) Achievement of a serum creatinine ≥ 354 µmol/L with evidence of a minimum increase of 27 µmol/L from pre-morbid baseline or during the current hospitalization; OR iii) Urine output < 6.0 mL/kg over the preceding 12 hours
NCT02937935	Patients with cirrhosis (diagnosed based on clinical, biochemical, radiological or histological diagnosis) with stage 3 Acute Kidney Injury defined as an increase of serum creatinine to more than 300 fold and more than 4 mg/dl.
NCT03343340	- Patients with ACLF defined based on APASL criteria with septic shock associated AKI
NCT03396757	All of the following criteria must be fulfilled to be included in the observational study (first stage): Adults (>18 years) Hospitalized in a study ICU. Evidence of acute kidney injury compatible with the diagnosis of acute tubular necrosis in a context of ischemic or toxic aggression and who receive (or received for the same episode) invasive mechanical ventilation and/or catecholamine infusion. Acute kidney injury stage 3 of KDIGO classification defined by at least one of the following criteria: serum creatinine concentration of more than 4 mg/dl (354 µmol/liter) or greater than 3 times the baseline creatinine level, anuria (urine output of 100 ml/day or less) for more than 12 hours, oliguria (urine output below 0.3 ml/kg/h or below 500 ml/day) for more than 24 hours. To be randomized (randomization stage), supplemental criteria must be fulfilled. These criteria can appear either immediately after inclusion in the observational stage, or during the follow-up of the patient in the observational stage, in the absence of any non-inclusion criteria (listed below) at the time of randomization: Oliguria/anuria (urine output <0.3 ml/kg/h or <500 ml/day) for more than 72 hours or serum urea concentration comprised between 40 and 50 mmol/l. Affiliation to a social security regime
NCT02937961	Patients with Cirrhosis with septic shock associated AKI (Acute Kidney Injury) stage 3 AKIN/KDIGO stage 2.
NCT03175328	patients will eligible if they are adults (18 years of age or older) who were admitted to the ICU with SAKI at KDIGO stage 2.
NCT01062984	Age 18 or older and able to sign consent (or surrogate). Must have been referred to the inpatient Nephrology consult service for evaluation of AKI. Expected survival of at least 48 hours.
NCT02669589	Critically ill patients with clinical indication for CRRT (clinical decision to use continuous RRT due to hemodynamic instability) Or Severe acute kidney injury (KDIGO 3-classification) despite optimal resuscitation At least one of the following conditions Sepsis or septic shock Use of catecholamines (norepinephrine or epinephrine ≥ 0.1 µg/kg/min or norepinephrine ≥ 0.05 µg/kg/min + dobutamine (any dose) or norepinephrine ≥ 0.05 µg/kg/min + vasopressin (any dose) or epinephrine ≥ 0.05 µg/kg/min + norepinephrine ≥ 0.05 µg/kg/min) Refractory fluid overload: worsening pulmonary edema: PaO2/FiO2 < 300 mmHg and/or fluid balance > 10% of body weight) 18-90 years old Intention to provide full intensive care treatment for at least 3 days Written informed consent of the patient or the legal representatives or the authorized representative or the inclusion due to an emergency situation
NCT02384525	body temperature < 36 °C or > 38 °C heart rate > 90 BPM respiratory rate > 20 or aPaCO2 < 32 mmHg on ABG White blood cell count < 4,000 cells/mm3 or > 12,000 cells/mm3 or band forms (immature white blood cells) ≥10% Evidence of infection WBCs in normally sterile fluid Perforated viscus radiologically proven infection more than Injury stage in AKI according to RIFLE criteria septic AKI which is not explained by other cause patients signed a written informed consent.
NCT03329313	Age > 18 years old Acute kidney injury requiring renal replacement therapy Dialysis type: on line sustained low efficiency dialysis -filtration SOFA score > 5 Sodium serum level between 135 and 145mmol/l
NCT03438877	Age older than 18 years; Be diagnosed as AKI according to KDIGO recommendation; Having indications for renal replacement therapy.
NCT02786277	Phase 1 of the trial will enroll all inpatients at study hospitals who meet Kidney Disease: Improving Global Outcomes Stage 1 Creatinine criteria for AKI Phase 2 and phase 3 of the trial will use a machine-learning based algorithm to target enrollment to those patients expected to derive benefit from alerting, based upon our experience in the prior trial period.
NCT02753751	Adult ≥ 18 years admitted to a participating study hospital Acute Kidney Injury as defined by KDIGO consensus creatinine criteria (0.3mg/dl increase in serum creatinine over 48 hours or 50% relative increase over 7 days).
NCT02793167	adult patients with an Alert for AKI (based on KDIGO guidelines)
NCT02771977	Acute Kidney Injury based upon the Kidney Disease: Improving Global Outcomes creatinine criteria (a 0.3mg/dl increase over 48 hours or 50% increase over 7 days) and exposure within the past 24 hours to one of the following classes of medications: Non-steroidal anti-inflammatory drug Renin Angiotensin Aldosterone System Antagonists Proton Pump Inhibitors
NCT01621152	All patients who are admitted in adult ICUs in Mayo Clinic Rochester Foley catheter for hourly UOP measurement
NCT03219398	Subjects aged 18-60 years old undergoing laparoscopic surgery, with American Society of Anesthesiologist (ASA) 1, body mass index 18-25. Patients who agreed to participate in this study and sign informed consent.
NCT03534141	Liver transplantation from a donor after neurologic determination of death
NCT02928887	age greater than or equal to 18 years undergoing cardiopulmonary bypass surgery
NCT02643745	age >18 years patients undergoing scheduled cardiac surgery Informed consent
NCT03590028	Age >18 years old Initial ESTOP AKI score ≥0.12 within the last 8 hours.
NCT02643745	age >18 years patients undergoing scheduled cardiac surgery Informed consent
NCT03244514	Adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) Urinary [TIMP-2] * [IGFBP7] >= 0.3 4h after CPB Written informed consent
NCT03178435	All adult patients (≥18 year old) admitted to the intensive care unit and do not fulfill the criteria for the diagnosis of AKI by Kidney Disease Improving Global Outcome (KDIGO) definition
NCT03236103	Adult patients with VAD in place who are admitted to the hospital for acute medical illness during the study period. For those with multiple admissions during the study period only the first admission will be studied. Patients who are able to give consent. In case of patients that are mentally impaired we will obtain consent from power of attorney and when patients regain intact mental capacity, we will reobtain consent from the patient.
NCT03564314	Adult patients (18 years of age and older) who develop hospital-acquired acute kidney injury on identified general and vascular surgery units in Alberta
NCT02726620	60 years and older Inpatients Scheduled for a non-cardiac surgical procedure under general or central neuraxial anesthesia
NCT02915575	Age ≥ 18 yrs. At least a doubling of serum creatinine during hospitalization (including need for dialysis) Have a primary care physician (PCP) No nephrologist follow up arranged after hospital discharge
NCT02483039	Age ≥ 18 yrs. Kidney Disease Improving Global Outcomes (KDIGO) stage 2 AKI and above (including need for dialysis)
NCT03165552	All patients aged over 18 registered with the practice
NCT03015623	AKI, as determined by the Investigator based on his/her clinical judgment Able to tolerate indwelling intravascular access Has tolerated Continuous Renal Replacement Therapy for at least 12 hours prior to IP treatment Likely to require Continuous Renal Replacement Therapy for at least an additional 48 hours Ability to give informed consent
NCT02933892	Patients scheduled to undergo non-emergent cardiac catheterization at University Medical Center Hospital, Lubbock, TX from January 2016 to January 2018. Emergent cardiac catheterizations will be defined as a catheterization scheduled < 24 hours from a cardiac event. Patients willing to be randomized to TFA or TRA procedure. Patients signed and dated the informed consent agreeing to participate in the study. Patients with chronic kidney disease, defined as eGFR = 15-59mL/min defined by the MDRD formula. (eGFR is a standard of care measurement for all patients undergoing coronary intervention.). Patients ages 18-88 years old.