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10.1186/s13054-016-1272-y

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suck abstract from ncbi


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pmid27095379
      Crit+Care 2016 ; 20 (1 ): 111
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  • Protection of remote ischemic preconditioning against acute kidney injury: a systematic review and meta-analysis #MMPMID27095379
  • Hu J ; Liu S ; Jia P ; Xu X ; Song N ; Zhang T ; Chen R ; Ding X
  • Crit Care 2016[Apr]; 20 (1 ): 111 PMID27095379 show ga
  • BACKGROUND: Remote ischemic preconditioning (RIPC) is a promising approach to preventing acute kidney injury (AKI), but its efficacy is controversial. METHODS: A systematic review of 30 randomized controlled trials was conducted to investigate the effects of RIPC on the incidence and outcomes of AKI. Random effects model meta-analyses and meta-regressions were used to generate summary estimates and explore sources of heterogeneity. The primary outcome was incidence of AKI and hospital mortality. RESULTS: The total pooled incidence of AKI in the RIPC group was 11.5 %, significantly less than the 23.3 % incidence in the control group (P = 0.009). Subgroup analyses indicated that RIPC significantly reduced the incidence of AKI in the contrast-induced AKI (CI-AKI) subgroup from 13.5 % to 6.5 % (P = 0.000), but not in the ischemia/reperfusion-induced AKI (IR-AKI) subgroup (from 29.5 % to 24.7 %, P = 0.173). Random effects meta-regression indicated that RIPC tended to strengthen its renoprotective effect (q = 3.95, df = 1, P = 0.047) in these trials with a higher percentage of diabetes mellitus. RIPC had no significant effect on the incidence of stages 1-3 AKI or renal replacement therapy, change in serum creatinine and estimated glomerular filtration rate (eGFR), hospital or 30-day mortality, or length of hospital stay. But RIPC significantly increased the minimum eGFR in the IR-AKI subgroup (P = 0.006) compared with the control group. In addition, the length of ICU stay in the RIPC group was significantly shorter than in the control group (2.6 vs 2.0 days, P = 0.003). CONCLUSIONS: We found strong evidence to support the application of RIPC to prevent CI-AKI, but not IR-AKI.
  • |Acute Kidney Injury/etiology/mortality/*prevention & control [MESH]
  • |Humans [MESH]
  • |Incidence [MESH]
  • |Ischemic Preconditioning/methods/*trends [MESH]
  • |Kidney Function Tests [MESH]
  • |Risk Factors [MESH]


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