Remote Ischemic Preconditioning for the Prevention of Contrast-Induced Acute Kidney Injury in Diabetics Receiving Elective Percutaneous Coronary Intervention
Remote ischemic preconditioning (RIPC) induces transient episodes of ischemia by the occlusion of blood flow in non-target tissue, before a subsequent ischemia-reperfusion injury. When RIPC is applied before percutaneous coronary intervention (PCI), the kidneys may be protected against ischemia-repe...
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| creator | Balbir Singh, Gillian Ann, Soe Hee Park, Jongha Chung, Hyun Chul Lee, Jong Soo Kim, Eun-Sook Choi, Jung Il Lee, Jiho Kim, Shin-Jae Shin, Eun-Seok |
| description | Remote ischemic preconditioning (RIPC) induces transient episodes of ischemia by the occlusion of blood flow in non-target tissue, before a subsequent ischemia-reperfusion injury. When RIPC is applied before percutaneous coronary intervention (PCI), the kidneys may be protected against ischemia-reperfusion injury and subsequently contrast-induced acute kidney injury (CI-AKI). The aim of this study was to evaluate the efficacy of RIPC for the prevention of CI-AKI in patients with diabetes with pre-existing chronic kidney disease (CKD) undergoing elective PCI.
This randomized, double-blind, sham-controlled study enrolled patients with diabetes scheduled for elective PCI with eGFR ≤60 ml/min/1.73 m2 or urinary albumin creatinine ratio of >300 mg/g to receive either RIPC or the sham ischemic preconditioning.
One hundred and two patients (68.9 ± 8.2 years old, 47.1% men) were included. Baseline eGFR, creatinine and serum NGAL was similar between RIPC and control groups (48.5 ± 12 ml/min vs. 46.6 ± 10 ml/min, p = 0.391; 1.42 ± 0.58 mg/dl vs. 1.41 ± 0.34 mg/dl, p = 0.924; and 136.0 ± 45.0 ng/ml vs. 137.6 ± 43.3 ng/ml, p = 0.961, respectively). CI-AKI occurred in 13.7% (14/102) of the total subjects, with both RIPC and control groups having an equal incidence of 13.7% (7/51). No significant differences were seen in creatinine, NGAL, cardiac enzymes (troponin T, CKMB) and hs-CRP between the groups post-procedure.
In this study, RIPC applied prior to elective PCI was not effective in preventing CI-AKI in patients with diabetes with pre-existing CKD.
ClinicalTrials.gov NCT02329444. |
| doi_str_mv | 10.1371/journal.pone.0164256 |
| format | Article |
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This randomized, double-blind, sham-controlled study enrolled patients with diabetes scheduled for elective PCI with eGFR ≤60 ml/min/1.73 m2 or urinary albumin creatinine ratio of >300 mg/g to receive either RIPC or the sham ischemic preconditioning.
One hundred and two patients (68.9 ± 8.2 years old, 47.1% men) were included. Baseline eGFR, creatinine and serum NGAL was similar between RIPC and control groups (48.5 ± 12 ml/min vs. 46.6 ± 10 ml/min, p = 0.391; 1.42 ± 0.58 mg/dl vs. 1.41 ± 0.34 mg/dl, p = 0.924; and 136.0 ± 45.0 ng/ml vs. 137.6 ± 43.3 ng/ml, p = 0.961, respectively). CI-AKI occurred in 13.7% (14/102) of the total subjects, with both RIPC and control groups having an equal incidence of 13.7% (7/51). No significant differences were seen in creatinine, NGAL, cardiac enzymes (troponin T, CKMB) and hs-CRP between the groups post-procedure.
In this study, RIPC applied prior to elective PCI was not effective in preventing CI-AKI in patients with diabetes with pre-existing CKD.
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This randomized, double-blind, sham-controlled study enrolled patients with diabetes scheduled for elective PCI with eGFR ≤60 ml/min/1.73 m2 or urinary albumin creatinine ratio of >300 mg/g to receive either RIPC or the sham ischemic preconditioning.
One hundred and two patients (68.9 ± 8.2 years old, 47.1% men) were included. Baseline eGFR, creatinine and serum NGAL was similar between RIPC and control groups (48.5 ± 12 ml/min vs. 46.6 ± 10 ml/min, p = 0.391; 1.42 ± 0.58 mg/dl vs. 1.41 ± 0.34 mg/dl, p = 0.924; and 136.0 ± 45.0 ng/ml vs. 137.6 ± 43.3 ng/ml, p = 0.961, respectively). CI-AKI occurred in 13.7% (14/102) of the total subjects, with both RIPC and control groups having an equal incidence of 13.7% (7/51). No significant differences were seen in creatinine, NGAL, cardiac enzymes (troponin T, CKMB) and hs-CRP between the groups post-procedure.
In this study, RIPC applied prior to elective PCI was not effective in preventing CI-AKI in patients with diabetes with pre-existing CKD.
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blood supply</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Lipocalin-2 - blood</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Neutrophils</subject><subject>Occlusion</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention</subject><subject>Preconditioning</subject><subject>Prevention</subject><subject>Reperfusion</subject><subject>Signal transduction</subject><subject>Troponin</subject><subject>Troponin T</subject><subject>Troponin T - blood</subject><subject>Type 2 diabetes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99u0zAUxiMEYmPwBggiISG4aHFsJ3ZukKYxoGLSUPlza7n2cesqtYvtVOxheFccmk0r2sUUKbFOft_n4-NziuJ5haYVYdW7te-Dk9106x1MUdVQXDcPiuOqJXjSYEQe3lofFU9iXCNUE940j4sjzBgmnLTHxZ85bHyCchbVCjZWlV8DKO-0TdY765al8aFMKxjiO3BDtPSmPPMuBRnTZOZ0r0CXp6rPLl-sdnBVzty6D1eldeUHKxeQrIrlHBTY3eB43oFKdpctIWSVdOD7mB2DdzIM4gRh3Opp8cjILsKz8XtS_Ph4_v3s8-Ti8tPs7PRiohiu00SjRcuwQVxJUnGt65o1hBDGoJFaG9JWEpmG1YCp0VIijlvNW1RTWJBFC4qcFC_3vtvORzFWNoqKY9ZgwhDOxGxPaC_XYhvsJucqvLTiX8CHpZAhH7QDgSk1rZI1rrmkirEWKsRNgxtaG8woyl7vx936xQa0gqGW3YHp4R9nV2Lpd6JGdcMozwZvRoPgf_UQk9jYqKDr9rXMeROG25Zzch-0zt1E8_ukePUfenchRmop81mtMz6nqAZTcUpZxXPtCc3U9A4qP3postyxxub4geDtgSAzCX6npexjFLNv8_uzlz8P2de32BXILq2i7_qhu-IhSPegCj7GAObmPiokhoG7roYYBk6MA5dlL27f5Y3oesLIXwrpJ6s</recordid><startdate>20161010</startdate><enddate>20161010</enddate><creator>Balbir Singh, Gillian</creator><creator>Ann, Soe Hee</creator><creator>Park, Jongha</creator><creator>Chung, Hyun Chul</creator><creator>Lee, Jong Soo</creator><creator>Kim, Eun-Sook</creator><creator>Choi, Jung Il</creator><creator>Lee, Jiho</creator><creator>Kim, Shin-Jae</creator><creator>Shin, Eun-Seok</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20161010</creationdate><title>Remote Ischemic Preconditioning for the Prevention of Contrast-Induced Acute Kidney Injury in Diabetics Receiving Elective Percutaneous Coronary Intervention</title><author>Balbir Singh, Gillian ; Ann, Soe Hee ; Park, Jongha ; Chung, Hyun Chul ; Lee, Jong Soo ; Kim, Eun-Sook ; Choi, Jung Il ; Lee, Jiho ; Kim, Shin-Jae ; Shin, Eun-Seok</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-d0b972f08ca318dd557633377e6addf391a0f675e24fdaa0829d89054eb3b9ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - prevention & control</topic><topic>Aged</topic><topic>Albumin</topic><topic>Angioplasty</topic><topic>Balloon angioplasty</topic><topic>Biology and Life Sciences</topic><topic>Blood flow</topic><topic>C-Reactive Protein - analysis</topic><topic>Calcium-binding protein</topic><topic>Cardiology</topic><topic>Chronic kidney failure</topic><topic>Contrast agents</topic><topic>Contrast Media - adverse effects</topic><topic>Coronary Disease - therapy</topic><topic>Coronary vessels</topic><topic>Creatine Kinase, MB Form - blood</topic><topic>Creatinine</topic><topic>Creatinine - blood</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - pathology</topic><topic>Diabetes therapy</topic><topic>Diabetics</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Double-Blind Method</topic><topic>Endocrinology</topic><topic>Enzymes</topic><topic>Epidermal growth factor receptors</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Injury prevention</topic><topic>Intervention</topic><topic>Ischemia</topic><topic>Ischemic Preconditioning</topic><topic>Kidney - 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Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Balbir Singh, Gillian</au><au>Ann, Soe Hee</au><au>Park, Jongha</au><au>Chung, Hyun Chul</au><au>Lee, Jong Soo</au><au>Kim, Eun-Sook</au><au>Choi, Jung Il</au><au>Lee, Jiho</au><au>Kim, Shin-Jae</au><au>Shin, Eun-Seok</au><au>Fukumoto, Yoshihiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Remote Ischemic Preconditioning for the Prevention of Contrast-Induced Acute Kidney Injury in Diabetics Receiving Elective Percutaneous Coronary Intervention</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-10-10</date><risdate>2016</risdate><volume>11</volume><issue>10</issue><spage>e0164256</spage><epage>e0164256</epage><pages>e0164256-e0164256</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Remote ischemic preconditioning (RIPC) induces transient episodes of ischemia by the occlusion of blood flow in non-target tissue, before a subsequent ischemia-reperfusion injury. When RIPC is applied before percutaneous coronary intervention (PCI), the kidneys may be protected against ischemia-reperfusion injury and subsequently contrast-induced acute kidney injury (CI-AKI). The aim of this study was to evaluate the efficacy of RIPC for the prevention of CI-AKI in patients with diabetes with pre-existing chronic kidney disease (CKD) undergoing elective PCI.
This randomized, double-blind, sham-controlled study enrolled patients with diabetes scheduled for elective PCI with eGFR ≤60 ml/min/1.73 m2 or urinary albumin creatinine ratio of >300 mg/g to receive either RIPC or the sham ischemic preconditioning.
One hundred and two patients (68.9 ± 8.2 years old, 47.1% men) were included. Baseline eGFR, creatinine and serum NGAL was similar between RIPC and control groups (48.5 ± 12 ml/min vs. 46.6 ± 10 ml/min, p = 0.391; 1.42 ± 0.58 mg/dl vs. 1.41 ± 0.34 mg/dl, p = 0.924; and 136.0 ± 45.0 ng/ml vs. 137.6 ± 43.3 ng/ml, p = 0.961, respectively). CI-AKI occurred in 13.7% (14/102) of the total subjects, with both RIPC and control groups having an equal incidence of 13.7% (7/51). No significant differences were seen in creatinine, NGAL, cardiac enzymes (troponin T, CKMB) and hs-CRP between the groups post-procedure.
In this study, RIPC applied prior to elective PCI was not effective in preventing CI-AKI in patients with diabetes with pre-existing CKD.
ClinicalTrials.gov NCT02329444.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27723839</pmid><doi>10.1371/journal.pone.0164256</doi><tpages>e0164256</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-10, Vol.11 (10), p.e0164256-e0164256 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1827623702 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acute Kidney Injury - etiology Acute Kidney Injury - prevention & control Aged Albumin Angioplasty Balloon angioplasty Biology and Life Sciences Blood flow C-Reactive Protein - analysis Calcium-binding protein Cardiology Chronic kidney failure Contrast agents Contrast Media - adverse effects Coronary Disease - therapy Coronary vessels Creatine Kinase, MB Form - blood Creatinine Creatinine - blood Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - pathology Diabetes therapy Diabetics Disease control Disease prevention Double-Blind Method Endocrinology Enzymes Epidermal growth factor receptors Female Glomerular Filtration Rate Heart diseases Humans Injury prevention Intervention Ischemia Ischemic Preconditioning Kidney - blood supply Kidney diseases Kidneys Lipocalin-2 - blood Male Medical imaging Medical research Medicine Medicine and Health Sciences Middle Aged Nephrology Neutrophils Occlusion Patients Percutaneous Coronary Intervention Preconditioning Prevention Reperfusion Signal transduction Troponin Troponin T Troponin T - blood Type 2 diabetes |
| title | Remote Ischemic Preconditioning for the Prevention of Contrast-Induced Acute Kidney Injury in Diabetics Receiving Elective Percutaneous Coronary Intervention |
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