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Remote ischemic preconditioning to reduce contrast-induced nephropathy: study protocol for a randomized controlled trial.
Trials 2014; 15:119T

Abstract

BACKGROUND

Despite the increasing use of pre- and posthydration protocols and low-osmolar instead of high-osmolar iodine-containing contrast media, the incidence of contrast-induced nephropathy (CIN) is still significant. There is evidence that contrast media cause ischemia-reperfusion injury of the medulla. Remote ischemic preconditioning (RIPC) is a non-invasive, safe, and low-cost method to reduce ischemia-reperfusion injury.

METHODS

The RIPCIN study is a multicenter, single-blinded, randomized controlled trial in which 76 patients at risk of CIN will receive standard hydration combined with RIPC or hydration with sham preconditioning. RIPC will be applied by four cycles of 5 min ischemia and 5 min reperfusion of the forearm by inflating a blood pressure cuff at 50 mmHg above the actual systolic pressure. The primary outcome measure will be the change in serum creatinine from baseline to 48 to 72 h after contrast administration.

DISCUSSION

A recent pilot study reported that RIPC reduced the incidence of CIN after coronary angioplasty. The unusual high incidence of CIN in this study is of concern and limits its generalizability. Therefore, we propose a randomized controlled trial to study whether RIPC reduces contrast-induced kidney injury in patients at risk for CIN according to the Dutch guidelines.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN76496973.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableDepartment of Surgery, Division of Vascular- and Transplant Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, Nijmegen, GA 6525, the Netherlands. m.warle@chir.umcn.nl.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24721127

Citation

Sterenborg, Thomas B., et al. "Remote Ischemic Preconditioning to Reduce Contrast-induced Nephropathy: Study Protocol for a Randomized Controlled Trial." Trials, vol. 15, 2014, p. 119.
Sterenborg TB, Menting TP, de Waal Y, et al. Remote ischemic preconditioning to reduce contrast-induced nephropathy: study protocol for a randomized controlled trial. Trials. 2014;15:119.
Sterenborg, T. B., Menting, T. P., de Waal, Y., Donders, R., Wever, K. E., Lemson, M. S., ... Warlé, M. C. (2014). Remote ischemic preconditioning to reduce contrast-induced nephropathy: study protocol for a randomized controlled trial. Trials, 15, p. 119. doi:10.1186/1745-6215-15-119.
Sterenborg TB, et al. Remote Ischemic Preconditioning to Reduce Contrast-induced Nephropathy: Study Protocol for a Randomized Controlled Trial. Trials. 2014 Apr 11;15:119. PubMed PMID: 24721127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Remote ischemic preconditioning to reduce contrast-induced nephropathy: study protocol for a randomized controlled trial. AU - Sterenborg,Thomas B, AU - Menting,Theo P, AU - de Waal,Yvonne, AU - Donders,Rogier, AU - Wever,Kimberley E, AU - Lemson,M Susan, AU - van der Vliet,Daan J A, AU - Wetzels,Jack F, AU - SchultzeKool,Leo J, AU - Warlé,Michiel C, Y1 - 2014/04/11/ PY - 2013/09/10/received PY - 2014/04/01/accepted PY - 2014/4/12/entrez PY - 2014/4/12/pubmed PY - 2014/10/22/medline SP - 119 EP - 119 JF - Trials JO - Trials VL - 15 N2 - BACKGROUND: Despite the increasing use of pre- and posthydration protocols and low-osmolar instead of high-osmolar iodine-containing contrast media, the incidence of contrast-induced nephropathy (CIN) is still significant. There is evidence that contrast media cause ischemia-reperfusion injury of the medulla. Remote ischemic preconditioning (RIPC) is a non-invasive, safe, and low-cost method to reduce ischemia-reperfusion injury. METHODS: The RIPCIN study is a multicenter, single-blinded, randomized controlled trial in which 76 patients at risk of CIN will receive standard hydration combined with RIPC or hydration with sham preconditioning. RIPC will be applied by four cycles of 5 min ischemia and 5 min reperfusion of the forearm by inflating a blood pressure cuff at 50 mmHg above the actual systolic pressure. The primary outcome measure will be the change in serum creatinine from baseline to 48 to 72 h after contrast administration. DISCUSSION: A recent pilot study reported that RIPC reduced the incidence of CIN after coronary angioplasty. The unusual high incidence of CIN in this study is of concern and limits its generalizability. Therefore, we propose a randomized controlled trial to study whether RIPC reduces contrast-induced kidney injury in patients at risk for CIN according to the Dutch guidelines. TRIAL REGISTRATION: Current Controlled Trials ISRCTN76496973. SN - 1745-6215 UR - https://www.unboundmedicine.com/medline/citation/24721127/Remote_ischemic_preconditioning_to_reduce_contrast_induced_nephropathy:_study_protocol_for_a_randomized_controlled_trial_ L2 - https://trialsjournal.biomedcentral.com/articles/10.1186/1745-6215-15-119 DB - PRIME DP - Unbound Medicine ER -