ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO082

Effect of Remote Ischemic Preconditioning to Prevent AKI in CKD Patients Undergoing Contrast-Enhanced Computed Tomography: A Randomized Controlled Trial

Session Information

  • AKI: Clinical Outcomes, Trials
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Goyadoolya, Pruedtinart, Phramongkutklao Hospital, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao Hospital, Bangkok, Thailand
  • Tasanavipas, Pamila, Phramongkutklao Hospital, Bangkok, Thailand
  • Varothai, Narittaya, Phramongkutklao Hospital, Bangkok, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao Hospital, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao Hospital, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao Hospital, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao Hospital, Bangkok, Thailand
Background

Chronic kidney disease (CKD) is an important risk factor of contrast-induced acute kidney injury (CI-AKI). Remote ischemic preconditioning (RIPC); transient ischemia followed by reperfusion of the extremity may subsequently protect against ischemia-induced injury in the other organs. Whether RIPC can prevent CI-AKI after contrast-enhanced computed tomography (CT) is not known.

Methods

We conducted a randomized controlled trial in CKD patients, glomerular infiltration rate (GFR) less than 60 mL/min/1.73m2, whom underwent contrast-enhanced CT during July 2018 to January 2019 at Phramongkutklao Hospital. All patients received standard protocol to prevent CI-AKI. Patients were allocated in 1:1 ratio to receive RIPC or not (control) by using block of 4 randomization.RIPC consistsof 4 cycles of 5 minutes of cuff to induce arm ischemia with 5 minutes of reperfusionbefore undergoing contrast-enhanced CT. All patients were closely monitored for possible complications.

Results

A total of 70 CKD patients (35 in the RIPC group, 35 in the control group) were enrolled. Mean age was 73.6±9.9 years and baseline GFR was 45.3±12.2 mL/min/1.73m2. Forty-two (60%) patients were male. The incidence of CI-AKI is lower in the RIPCgroup than the control group (8.57% vs 0%), p-value=0.07. Changes of serum creatinine from baseline to 48-hour and from 24-hour to 48-hour were better in the RIPC group than the control group; -0.09 ±0.16 vs -0.02±0.20 mg/dL, p-value=0.13 and 0.00±0.12 vs 0.08±0.17 mg/dL, p-value = 0.03, respectively. Change of GFR from 24-hour to 48-hour was also better in the RIPC group than the control group; -0.0±5.4 vs -2.4±6.3 mL/min/1.73m2. In the RIPC group, 25 (71.4%) patients had local numbness. Eighteen (51.4%) patients experienced armpain, mean pain score 3.1±1.2 out of 10, which immediately resolved after the procedure. No serious complication was observed.

Conclusion

RIPC may decrease the risk of CI-AKI in CKD patient undergoing contrast-enhanced CT, without any serious side effect.