title: Remote ischemic preconditioning for prevention of contrast-induced acute kidney injury in diabetic patients.
abstract: BACKGROUND
  There are some clinical trials showing that short-term ischemia in one organ can protect different organs against higher intensity and longer ischemic insult. We designed a study to assess whether remote ischemic preconditioning (RIPC) on one organ can decrease the rate of contrast-induced acute kidney injury (AKI) in diabetic patients who undergo coronary artery angiography (CAA).
  
  
  METHODS
  This randomized control trial included 96 diabetic patients who were candidates for CAA. Exclusion criteria were congestive heart failure and complications during CAA. All of the patients received 1000 mL of normal saline before CAA. The RIPC group underwent 3 cycles of 5-minute ischemia in their right arm. Serum creatinine was measured before and 24 hours after CAA.
  
  
  RESULTS
  Contrast-induced AKI was reported in 5 cases in the control group and 1 case in the RIPC group (P = .13, odds ratio, 5.4). The differences in serum creatinine level before and after the procedure was significantly lower in RIPC group than that in the control group (P = .04, odds ratio, 0.08). Serum creatinine rise significantly correlated with contrast dose (P = .02) and a history of hypertension (P = .02) in both groups.
  
  
  CONCLUSIONS
  Ischemic preconditioning had a protective effect on contrast-induced AKI in our study. Since this method is harmless and cost effective, further studies on patients with chronic kidney disease is required to evaluate addition of ischemic preconditioning to our clinical practice for prevention of contrast-induced AKI.
authors.affiliation: Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. ssavaj@hotmail.com.
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Savaj
authors.forename: Javad
authors.initials: J
authors.lastname: Savoj
authors.forename: Ismail
authors.initials: I
authors.lastname: Jebraili
authors.forename: Seyed Hashem
authors.initials: SH
authors.lastname: Sezavar
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications / Q000139:chemically induced* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning; D008297:Male; D008875:Middle Aged
chemical_list: D003287:Contrast Media; D003404:Creatinine