Failure of remote ischemic preconditioning to reduce the risk of postoperative acute kidney injury in children undergoing operation for complex congenital heart disease: A randomized single-center study

Pedersen, Kirsten; Ravn, Hanne Berg; Povlsen, Johan Vestergaard; Schmidt, Michael; Erlandsen, Erland J.; Hjortdal, Vibeke E.

doi:10.1016/j.jtcvs.2011.08.044

Cited by 68 publications

(57 citation statements)

References 24 publications

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“…Thus, the trial of leg preconditioning in children undergoing surgery for complex congenital cardiac disease found no evidence that rIPC protected renal function. 73 End points were AKI development, initiation of dialysis, plasma creatinine, eGFR, plasma cystatin C, plasma and urinary neutrophil gelatinase-associated lipocalin, and urinary output. Similar results were reported by another study on 76 patients undergoing complex valvular heart surgery.…”

mentioning

confidence: 99%

Remote Ischemic Preconditioning and Renoprotection

Gassanov¹,

Nia

Caglayan³

et al. 2014

Journal of the American Society of Nephrology

123

106

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There is currently no effective prophylactic regimen available to prevent contrastinduced AKI (CI-AKI), a frequent and life-threatening complication after cardiac catheterization. Therefore, novel treatment strategies are required to decrease CI-AKI incidence and to improve clinical outcomes in these patients. Remote ischemic preconditioning (rIPC), defined as transient brief episodes of ischemia at a remote site before a subsequent prolonged ischemia/reperfusion injury of the target organ, is an adaptational response that protects against ischemic and reperfusion insult. Indeed, several studies demonstrated the tissue-protective effects of rIPC in various target organs, including the kidneys. In this regard, rIPC may offer a novel noninvasive and virtually cost-free treatment strategy for decreasing CI-AKI incidence. This review evaluates the current experimental and clinical evidence for rIPC as a potential renoprotective strategy, and discusses the underlying mechanisms and key areas for future research.

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mentioning

confidence: 99%

Remote Ischemic Preconditioning and Renoprotection

Gassanov¹,

Nia

Caglayan³

et al. 2014

Journal of the American Society of Nephrology

123

106

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“…Cystatin C and NGAL as novel biomarkers have not been used and validated in animal studies. Nevertheless, they have recently been reported as early detectors of renal failure in clinical setups of RIPC [23,24,26,38,39,40]. In all these clinical studies, no benefit of RIPC has been found.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis of 13 clinical trials including patients who underwent cardiac and vascular interventions, RIPC was considered as potentially beneficial for the prevention of acute kidney injury, but the currently available information is not robust enough to make a recommendation [22]. However, other studies have not demonstrated a protective effect of RIPC against renal impairment after various procedures, such as infrarenal AAA repair [23] and heart surgery in adults [24], children [25] or neonates [26]. …”

Section: Introductionmentioning

confidence: 99%

Remote Ischemic Preconditioning May Attenuate Renal Ischemia-Reperfusion Injury in a Porcine Model of Supraceliac Aortic Cross-Clamping

Athanasiadis

Kapelouzou²,

Martikos³

et al. 2015

J Vasc Res

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Aim: The effect of remote ischemic preconditioning (RIPC) in decreasing renal ischemia-reperfusion injury (IRI) during a suprarenal aortic cross-clamping was examined in a swine model. Materials and Methods: Four groups of pigs were examined: (a) ischemia-reperfusion (IR) group, renal IRI produced by 30 min of supraceliac aortic cross-clamping; (b) RIPC I group, the same renal IRI following RIPC by brief occlusion of the infrarenal aorta (15 min ischemia and 15 min reperfusion); (c) RIPC II group, the same renal IRI following RIPC by brief occlusion of the infrarenal aorta (3 cycles of 5 min ischemia and 5 min reperfusion); (d) sham group. Renal function was assessed before and after IRI by examining creatinine, neutrophil gelatinase-associated lipocalin (NGAL), TNF-α, malondialdehyde (MDA), cystatin C and C-reactive protein (CRP) from renal vein blood samples at specific time intervals. Results: Both RIPC groups presented significantly less impaired results compared to the IR group when considering MDA, cystatin C, CRP and creatinine. Between the two RIPC groups, RIPC II presented a better response with regard to CRP, NGAL, TNF-α, MDA and cystatin C. Conclusions: Remote IR protocols and mainly repetitive short periods of cycles of IR ameliorate the biochemical kidney effects of IRI in a model of suprarenal aortic aneurysm repair.

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“…В 2012 г. опубликованы результаты клинических наблюде-ний 113 детей (возраст от 0 до 15 лет), которым выполнялась хи-рургическая коррекция пороков сердца [54]. Поражение почек оценивали по нескольким показателям: СКФ, содержание в плазме крови креатинина, NGAL и цистатина-С, концентрация в моче NGAL.…”

Section: терапевтический архив 8 2016unclassified

“…Поражение почек оценивали по нескольким показателям: СКФ, содержание в плазме крови креатинина, NGAL и цистатина-С, концентрация в моче NGAL. Установлено, что ДИП не влияет ни на один из ука-занных показателей [54]. Год спустя B. Jones и соавт.…”

Section: терапевтический архив 8 2016unclassified

Neuroprotective and nephroprotective effects of remote postconditioning: Prospects for clinical use

Maslov

Tsibulnikov

Цепокина

et al. 2016

Terapevticheskii arkhiv

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1 фГБну «нИИ кардиологии», Томск, россия; 2 национальный исследовательский Томский политехнический университет, Томск, россия; 3 фГБну нИИ комплексных проблем сердечно-сосудистых заболеваний, Кемерово, россия; 4 республиканский научно-прак-тический центр «Кардиология», Минск, Беларусь Аннотация результаты экспериментальных и клинических исследований убедительно свидетельствуют, что дистантное ишемическое прекондиционирование (ДИП) не оказывает нейропротекторного эффекта при кардиохирургических вмешательствах, выполняемых в условиях искусственного кровообращения. Дистантное прекондиционирование (ДК) не оказывает нейро-протекторного эффекта при геморрагическом инсульте. необходимо проведение рандомизированного многоцентрового исследования для оценки эффективности ДИП у пациентов с ишемическим инсультом. ДК снижает выраженность ишеми-ческого и реперфузионного повреждения почки при трансплантации. установлено, что ДИП предупреждает появление нефропатии, индуцированной контрастным веществом. необходимо многоцентровое исследование для оценки эффек-тивности ДИП у пациентов с протезированием аневризмы брюшной аорты. Анализ представленных данных свидетель-ствует, что ДИП не предупреждает возникновение кардиоренального синдрома у новорожденных и детей при выполнении кардиохирургических вмешательств. Данные литературы о способности ДИП оказывать нефропротекторный эффект у пациентов с коронарным шунтированием носят противоречивый характер и свидетельствуют о целесообразности про-ведения многоцентрового исследования. The results of experimental and clinical studies strongly suggest that remote ischemic preconditioning (rIP) has no neuroprotective effect during cardiac surgery performed under extracorporeal circulation. remote preconditioning (rP) has no neuroprotective effect in hemorrhagic stroke. A randomized multicenter study is needed to evaluate the efficiency rIP in patients with ischemic stroke. rP reduces the severity of ischemia/reperfusion kidney injury during transplantation. rIP has been established to prevent contrast-induced nephropathy. There is a need for a multicenter trial to evaluate the efficiency of rIP in patients with abdominal aortic aneurysm repair. Analysis of the presented data indicates that rIP fails to prevent cardiorenal syndrome in infants and children during cardiac surgery. The data available in the literature on the capacity of rIP to provide nephroprotective effect in patients after coronary artery bypass surgery are discordant and indicative of the advisability of a multicenter study. Keywords: remote ischemic preconditioning, brain, kidneys.Дистантное ишемическое прекондиционирование (ДИП) -это феномен повышения устойчивости к длительной ишемии и реперфузии одного органа после кратковременной ишемии-ре-перфузии другого органа. Полагают, что кратковременная ише-мия и реперфузия вызывают выброс в кровоток гуморального фактора(ов), которые повышают толерантность органов и тканей к ишемии и реперфузии [1][2][3][4][5][6][7]. Предполагают, что подобными факторами могут быть эндогенные каннабин...

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Failure of remote ischemic preconditioning to reduce the risk of postoperative acute kidney injury in children undergoing operation for complex congenital heart disease: A randomized single-center study

Abstract: We found no evidence that remote ischemic preconditioning provided protection of kidney function in children undergoing operation for complex congenital heart disease.

Cited by 68 publications

References 24 publications

Remote Ischemic Preconditioning and Renoprotection

Remote Ischemic Preconditioning and Renoprotection

Remote Ischemic Preconditioning May Attenuate Renal Ischemia-Reperfusion Injury in a Porcine Model of Supraceliac Aortic Cross-Clamping

Neuroprotective and nephroprotective effects of remote postconditioning: Prospects for clinical use

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