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Remote ischemic conditioning and renal function after contrast-enhanced CT scan: A randomized trial.

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Remote ischemic conditioning may protect kidneys from contrast-induced injury. This study found conditioning reduced the risk of increased serum creatinine (SCr) after contrast-enhanced computed tomography (CECT).

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Area of Science:

  • Nephrology
  • Cardiovascular Research
  • Radiology

Background:

  • Remote ischemic conditioning (RIC) shows protective effects against ischemia-reperfusion injury.
  • Emerging evidence suggests RIC may also mitigate contrast-induced kidney injury.

Purpose of the Study:

  • To evaluate the efficacy of RIC in preventing serum creatinine (SCr) elevation post-contrast-enhanced computed tomography (CECT).

Main Methods:

  • A randomized controlled trial (NCT 01741896) involving adult in-patients undergoing CECT.
  • The conditioning group received four cycles of cuff-induced arm ischemia/reperfusion ~40 minutes prior to CECT.
  • The primary outcome measured was the change in SCr after CECT.

Main Results:

  • No significant differences in baseline characteristics between the conditioned and control groups.
  • Overall, RIC reduced the risk ratio (RR) for increased SCr (RR 0.65; 95% CI 0.41-1.04).
  • A stronger protective effect was observed in patients with pre-existing reduced renal function (eGFR).

Conclusions:

  • Remote ischemic conditioning demonstrates a potential protective effect against contrast-induced kidney injury.
  • RIC may be a viable strategy to reduce the risk of acute kidney injury in patients undergoing CECT, particularly those with compromised renal function.