title: Using remote ischemic conditioning to reduce acute kidney injury in patients undergoing percutaneous coronary intervention: a meta-analysis.
abstract: OBJECTIVE
  It remains uncertain whether remote ischemic conditioning (RIC) could prevent acute kidney injury (AKI) in patients undergoing percutaneous coronary intervention (PCI). Thus, this meta-analysis aiming to explore the renoprotective role of RIC in patients undergoing PCI was carried out.
  
  
  METHODS
  PubMed, Web of Science, and Cochrane Library were searched from inception to 31 December 2014 to identify eligible randomized controlled trials. Pooled risk ratio, mean, standard deviation and 95% CI were used to assess the effect by fixed- or random-effect models. Heterogeneity was assessed by the Cochran Q and I( 2) statistics.
  
  
  RESULTS
  Nine trials were included in this study. RIC decreased the AKI incidence in patients undergoing PCI compared with control individuals (P < 0.001; RR, 0.53; 95% CI, 0.39-0.71; P for heterogeneity = 0.15; heterogeneity χ(2 )= 13.38; I(2 )= 33%). Besides, limb conditioning attenuated AKI (P = 0.001; RR, 0.57; 95% CI, 0.41-0.81; P for heterogeneity = 0.13; heterogeneity χ(2 )= 12.48; I(2 )= 36%). Remote postconditioning may reduce the AKI incidence (P = 0.03; RR, 0.65; 95% CI, 0.44-0.97; P for heterogeneity = 0.15; heterogeneity χ(2 )= 5.36; I(2 )= 44%); remote preconditioning could also play a renoprotective role (P < 0.001; RR, 0.42; 95% CI, 0.27-0.65; P for heterogeneity = 0.31; heterogeneity χ(2 )= 5.98; I(2 )= 16%).
  
  
  CONCLUSIONS
  RIC may not only confer cardioprotection, but also reduce the incidence of AKI in patients undergoing PCI, ultimately leading to better clinical outcomes. RIC may potentially be a powerful approach conferring protection in patients undergoing PCI in future clinical practice. More large-scale trials are required to obtain a more reliable conclusion.
authors.affiliation: a a Department of Cardiology , Peking University Third Hospital and Key Laboratory of Cardiovascular Molecular Biology and Regulatory peptides, Ministry of Health , Beijing , China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zuo
authors.affiliation: a a Department of Cardiology , Peking University Third Hospital and Key Laboratory of Cardiovascular Molecular Biology and Regulatory peptides, Ministry of Health , Beijing , China.
authors.forename: Fuhua
authors.initials: F
authors.lastname: Wang
authors.affiliation: a a Department of Cardiology , Peking University Third Hospital and Key Laboratory of Cardiovascular Molecular Biology and Regulatory peptides, Ministry of Health , Beijing , China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Song
authors.affiliation: b b Institute of Vascular Medicine, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education , Beijing , China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.affiliation: a a Department of Cardiology , Peking University Third Hospital and Key Laboratory of Cardiovascular Molecular Biology and Regulatory peptides, Ministry of Health , Beijing , China.
authors.forename: Guisong
authors.initials: G
authors.lastname: Wang
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D019194:Ischemic Preconditioning / Q000379:methods*; D007668:Kidney / Q000098:blood supply*; D017063:Outcome Assessment, Health Care; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*
keywords: Acute kidney injury; Complication; Meta-analysis; Percutaneous coronary intervention; Remote ischemic conditioning