The Effect of Remote Ischemic Preconditioning on the Incidence of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

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Bagheri Sina; Shahbazi Shahrbanoo; SHAFA MASIH; BORHANI HAGHIGHI AFSHIN; Kiani Mahsa; SAGHEB MOHAMMAD MAHDI

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Journal: IRANIAN JOURNAL OF MEDICAL SCIENCES (IJMS) Year:2018 | Volume:43 | Issue:6 Page(s): 587-595

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Title

The Effect of Remote Ischemic Preconditioning on the Incidence of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

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Keywords

Ischemic preconditioning

Reperfusion injury

Acute kidney injury

Coronary artery bypass

Abstract

Background: Remote Ischemic preconditioning (RIPC) protects other organs from subsequent lethal ischemic injury, but uncertainty remains. We investigated if RIPC could prevent Acute kidney injury (AKI) in patients undergoing Coronary artery bypass graft (CABG) surgery. Methods: This parallel-group, double-blind, randomized, controlled trial was done on adults undergoing elective or urgent on-pump CABG surgery from 2013 to 2017 in Shiraz, Iran. Patients were allocated to RIPC or control groups through permuted blocking. The patients in the RIPC group received three cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia. We placed an uninflated cuff on the arm for 30 min in the control group. The study primary endpoint was an incidence of AKI. Secondary endpoints included short-term clinical outcomes. We compared categorical and continuous variables using Pearson χ 2 and unpaired t tests, respectively. P<0. 05 was considered significant. Results: Of the 180 patients randomized to RIPC (n=90) and control (n=90) groups, 87 patients in the RIPC and 90 patients in the control group were included in the analysis. There was no significant difference in the incidence of AKI between the groups (38 patients [43. 7%] in the RIPC group and 41 patients [45. 6%] in the control group; relative risk, 0. 96; 95% confidence interval, 0. 69 to 1. 33; P=0. 80). No significant differences were seen regarding secondary endpoints such as postoperative liver function, atrial fibrillation, and inpatient mortality. Conclusion: RIPC did not reduce the incidence of AKI, neither did it improve short-term clinical outcomes in patients undergoing on-pump CABG surgery.

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APA: Copy

Bagheri, Sina, Shahbazi, Shahrbanoo, SHAFA, MASIH, BORHANI HAGHIGHI, AFSHIN, Kiani, Mahsa, & SAGHEB, MOHAMMAD MAHDI. (2018). The Effect of Remote Ischemic Preconditioning on the Incidence of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES (IJMS), 43(6), 587-595. SID. https://sid.ir/paper/754827/en

Vancouver: Copy

Bagheri Sina, Shahbazi Shahrbanoo, SHAFA MASIH, BORHANI HAGHIGHI AFSHIN, Kiani Mahsa, SAGHEB MOHAMMAD MAHDI. The Effect of Remote Ischemic Preconditioning on the Incidence of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES (IJMS)[Internet]. 2018;43(6):587-595. Available from: https://sid.ir/paper/754827/en

IEEE: Copy

Sina Bagheri, Shahrbanoo Shahbazi, MASIH SHAFA, AFSHIN BORHANI HAGHIGHI, Mahsa Kiani, and MOHAMMAD MAHDI SAGHEB, “The Effect of Remote Ischemic Preconditioning on the Incidence of Acute Kidney Injury in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial,” IRANIAN JOURNAL OF MEDICAL SCIENCES (IJMS), vol. 43, no. 6, pp. 587–595, 2018, [Online]. Available: https://sid.ir/paper/754827/en

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