Document Detail


Remote ischemic preconditioning has a neutral effect on the incidence of kidney injury after coronary artery bypass graft surgery.
MedLine Citation:
PMID:  25075773     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Acute kidney injury (AKI) is a frequent complication of cardiac surgery and usually occurs in patients with preexisting chronic kidney disease (CKD). Remote ischemic preconditioning (RIPC) may mitigate the renal ischemia-reperfusion injury associated with cardiac surgery and may be a preventive strategy for postsurgical AKI. We undertook a randomized controlled trial of RIPC to prevent AKI in 86 patients with CKD (estimated glomerular filtration rate under 60 ml/min per 1.73 m(2)) undergoing coronary artery bypass graft (CABG) surgery. Forty-three patients each were randomized to receive standard care with or without RIPC consisting of three 5-minute cycles of forearm ischemia followed by reperfusion. The primary end point was the development of AKI defined as an increase in serum creatinine concentration over 0.3 mg/dl within 48 h of surgery. Secondary end points included a comparison between the study and control groups of several serum biomarkers of renal injury including cystatin-C, neutrophil gelatinase-associated lipocalin (NGAL), and interleukin-18 (IL-18), and urinary biomarkers including NGAL, IL-18, and kidney injury molecule-1 measured at 6, 12, and 24 h after CABG, and the 72-h serum troponin T concentration area under the curve as a marker of myocardial injury. Clinical and operative characteristics were similar between the preconditioned and control groups. AKI developed in 12 patients in both groups within 48 h of CABG. There were no significant differences between the two groups in the concentrations of any of the serum or urinary biomarkers of renal or cardiac injury after CABG. Thus, RIPC induced by forearm ischemia-reperfusion had no effect on the frequency of AKI after CABG in patients with CKD.Kidney International advance online publication, 30 July 2014; doi:10.1038/ki.2014.259.
Authors:
Sean M Gallagher; Dan A Jones; Akhil Kapur; Andrew Wragg; Steve M Harwood; Rohini Mathur; R Andrew Archbold; Rakesh Uppal; Muhammad M Yaqoob
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-30
Journal Detail:
Title:  Kidney international     Volume:  -     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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