Remote ischaemic preconditioning reduces acute kidney injury in adult patients undergoing cardiac surgery with cardiopulmonary bypass: a meta-analysis.
This article represents the first attempt to perform a pooled analysis about remote ischaemic preconditioning (RIPC) in reduction of acute kidney injury (AKI) of adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A systematic search was performed using PubMed (1966-5 January 2016), the Cochrane Library (1996-5 January 2016), the Web of Science (1986-5 January 2016) and Chinese database (SinoMed) (1978-5 January 2016) to identify studies that have described the effect of RIPC on AKI in adult patients undergoing cardiac surgery with CPB. The outcomes used for this analysis included the incidence of AKI and the need for renal replacement therapy (RRT). Thirteen randomized controlled trials (4370 participants) were included in this analysis. RIPC significantly reduced the risk of AKI (risk ratio, 0.81; 95% confidence interval, [0.66, 0.99]; P = 0.04; I2 = 46%) for adult patients compared with control group. However, there was no significant difference with respect to the incidence of RRT between the two groups. The present meta-analysis found that RIPC may reduce the incidence of AKI among adult patients following cardiac surgery with CPB. Adequately powered trials are warranted to provide further corroboration of our findings in the future.
Department of Cardiothoracic Surgery, Heart Center, The First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.|Department of Extracorporeal Circulation, Heart Center, The First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
Bin
B
Yi
Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Xiang
X
Chen
Department of Extracorporeal Circulation, Heart Center, The First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
Han
H
Shi
Musculoskeletal Oncology Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Tiao
T
Lin
Scientific Research Section, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Haifeng
H
Lin
Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Yi
Y
Xu
Department of Extracorporeal Circulation, Heart Center, The First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
Jian
J
Rong
D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D006801:Humans; D019194:Ischemic Preconditioning / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D017582:Renal Replacement Therapy; D012680:Sensitivity and Specificity
Acute kidney injury; Adult patients; Cardiac surgery; Cardiopulmonary bypass; Meta-analysis; Remote ischaemic preconditioning