Ibrahim Gul, Abid Hussain Laghari, Azmina Artani, Aymen Shakeel Mirza, Javed Majid Tai, Khawar Abbas Kazmi.
Remote ischemic preconditioning, a novel renoprotective strategy against contrast induced acute kidney injury.
Pak Heart J Jan ;51(2):124-30.

Objective: To compare contrast induced Acute Kidney Injury amongst patients with stable angina, unstable angina and Non ST elevation myocardial infarction undergoing elective Coronary angiography and or percutaneous coronary intervention with versus without applying Remote Ischemia Preconditioning. Methodology: It is a randomized control trial conducted at The Aga Khan University Hospital, Karachi, from January, 2015 till June, 2015.Patients aged+-30 years, having baseline serum creatinine level +- 1.4mg/dl with the above mentioned conditions who were to undergo coronary angiography and or percutaneous coronary intervention were randomly assigned to one of either intervention group or control group. All patients received standard care followed by application of RIPC to the intervention arm only. Baseline characteristics of all patients were recorded and they were followed for 48 hours. The data was analyzed using STATA version 12.0. Results: Out of 103 patients, 53 were in Intervention arm and 50 in Control arm with an average age 65 and 66 years respectively. Majority were male in both the groups. The primary outcome (Contrast Induced Nephropathy) was significantly lower in the intervention arm vs control arm (3.7% vs 14%). Multivariable logistic regression analysis suggested a protective effect of the intervention (RIPC) with adjusted Odd Ratio of 0.07 (95% CI: 0.007-0.72, p-value: 0.026) Patients with prior MI were at higher risk for CI-AKI. Conclusion: Remote Ischemic Preconditioning has a significantly higher renal protective role against Contrast Induced Nephropathy.

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