Acute Kidney Injury
Conditions
Keywords
acute kidney injury, percutaneous coronary intervention, remote ischemic preconditioning
Brief summary
This single-center, randomized controlled trial is to investigate the impact of remote ischemic preconditioning (RIPC) on the risk contrast-induced acute kidney injury and its long-term impact on renal function for patients with diabetes undergoing percutaneous coronary intervention.
Detailed description
Patients with diabetes undergoing elective percutaneous coronary intervention in Beijing Anzhen Hospital were enrolled, and all the eligible participants were randomized to either remote ischemic preconditioning (RIPC) group or control group. Those randomized to RIPC group had a pneumatic medical tourniquet cuff (width , 5 cm ; length , 40 cm) placed around their upper arm at \< 2 hours before the PCI procedure. The pneumatic medical cuff was inflated to a pressure of 200 mm Hg for 5 minutes , followed by 5 minutes of deflation to allow reperfusion. This procedure was repeated for 3 times. Control participants did not experience this procedure of transient upper-limb ischemia.
Interventions
PROCEDUREremote ischemic preconditioning (RIPC)
Those randomized to RIPC group had a pneumatic medical tourniquet cuff (width , 5 cm ; length , 40 cm) placed around their upper arm at \< 2 hours before the PCI procedure. The pneumatic medical cuff was inflated to a pressure of 200 mm Hg for 5 minutes , followed by 5 minutes of deflation to allow reperfusion. This procedure was repeated for 3 times.
Sponsors
Beijing Anzhen Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients with diabetes undergoing percutaneous coronary intervention were included.
Exclusion criteria
1. emergency PCI, 2. baseline troponin value \> 0.04 ng/mL, 3. nicorandil or glibenclamide use (preconditioning-mimetic and preconditioning-blocking medication, respectively), 4. patient on dialysis, 5. patients who had some inability to cooperate with the trial, 6. those who could not give informed consent, and (7) second procedure of staged elective PCI in this hospitalization.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| acute kidney injury | 72 hours after procedure | The primary study endpoint was AKI, defined as an absolute rise in serum creatinine of ≥ 0.5 mg/dl or a relative increase of ≥ 25% compared to baseline within 72 hours from PCI (the maximal measured concentration of serum creatinine during these 72 hours was used). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| relative reduction in estimated glomerular filtration rate | 180 days after procedure | Secondary endpoints were the relative reduction in estimated glomerular filtration rate (eGFR) as well as all cause mortality, myocardial infarction and stent thrombosis at 30-day and 180-day after procedure. |
Countries
China
Outcome results
None listed