Publication date: 2017

DOI: 10.3233/CH-16184

BACKGROUND: Contrast-induced nephropathy (CIN) is a formidable side effect of iodinated contrast medium use in 7 subjects undergoing coronary angiogram (CAG). Remote ischemic preconditioning (RIPC) may reduce the risk of CIN. 8 AIM: The aim of the study was to investigate the nephroprotective effects of RIPC in coronary heart disease (CHD) in 9 patients, undergoing CAG, with mild to moderate lowered estimated glomerular filtration rate (eGFR). 10 MATERIALS: In the randomized, blinded, sham RIPC (sRIPC) controlled study 51 patients with CHD and GFR less than 80 mL/min/m2 11 , undergoing CAG, were investigated. The patients were randomized for RIPC (n = 26, 60.5 ± 2.0 years) or 12 sRIPC (n = 25, 62.96 ± 1.7). RIPC was performed before the CAG by means of 3–5-minute cycle cuff pumped on the upper arm 13 + 50 mm Hg above the systolic blood pressure (BP), while in sRIPC it corresponded to diastolic BP. The primary endpoint was 14 the development of CIN and secondary – change of biomarkers (creatinine, urea, neutrophil gelatinase-associated lipocalin 15 (NGAL), cystatin-C). 16 RESULTS: In RIPC group, CIN occurred in 28% of cases, while in sRIPC –3.8%. All investigated markers increased in 17 sRIPC and declined in RIPC; the difference was significant in markers between the groups before and after CAG. 18 CONCLUSIONS: RIPC proved nephroprotective effect in prevention of contrast-induced nephropathy in CHD subjects with mild to moderate lowered eGFR.

Тип: Article