Parikh CR, Liu C, Mor MK, et al. - Given that the PRESERVE trial (using a 2 × 2 factorial design) including patients with chronic kidney disease undergoing angiography was performed to compare intravenous saline solution with intravenous sodium bicarbonate solution and oral N-acetylcysteine with placebo as prophylaxis against 90-day major adverse kidney events and death (MAKE-D) and contrast-associated acute kidney injury (CA-AKI), researchers assessed preangiography injury and repair proteins, in urine and plasma, as predictors of MAKE-D, CA-AKI, as well as determined their influence on trial design. They found the association of preangiography levels of 4 plasma (KIM-1, NGAL, UMOD, and YKL-40) and 3 urine (NGAL, IL-18, and YKL-40) biomarkers, with MAKE-D, after adjusting for urinary albumin-creatinine ratio and baseline estimated glomerular filtration rate. A significant link with CA-AKI was demonstrated only by plasma KIM-1 level, after adjustment. In this study, MAKE-D development was modestly predicted by preangiography levels of injury and repair biomarkers. These can be employed to enhance the efficiency of future CA-AKI trials.