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Submitted: 24 Feb 2020
Accepted: 06 Jun 2020
ePublished: 24 Jul 2020
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J Nephropharmacol. 2021;10(1): e09.
doi: 10.34172/npj.2021.09
  Abstract View: 83
  PDF Download: 36

Original

The efficiency of remote ischemic preconditioning on serum cystatin C-based acute kidney injury in patients undergoing coronary angiography; a randomized controlled trial

Azadeh Moradkhani 1 ORCID logo, Hamid Reza Samimagham 2,3 * ORCID logo, Mohammad Tamaddondar 3, Hossein Farshidi 2, Mahmood Khayatian 4, Sanaz Soleimani 1 ORCID logo

1 Department of Internal Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2 Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3 Department of Nephrology and Internal Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
4 Molecular Medicine Research Center and Department of Biochemistry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
*Corresponding author: Hamid Reza Samimagham, E‐mail: samimagham@yahoo.com, hsamimagham@hums.ac.ir

Abstract

Introduction: Contrast-induced acute kidney injury (CI-AKI) is a known complication of cardiac interventions. Remote ischemic preconditioning (RIPC) is a non-pharmacological method which has a nephroprotective effect. Serum cystatin C (CysC) is a suitable biomarker for the early diagnosis of AKI.

Objectives: This study aimed to evaluate the incidence of CI-AKI after RIPC in patients undergoing coronary angiography, through assessment of CysC.

Patients and Methods: Around 140 patients with stable coronary artery disease undergoing angiography were randomly allocated to two groups of RIPC and control groups. In each group, the following biomarkers were assessed: serum creatinine (Cr) and CysC at baseline, 24-hour and 48-hour serum Cr and 24-hour CysC. The endpoint was the development of AKI based on either the KDIGO criteria or a 15% increase in serum CysC.

Results: No significant difference was observed between two groups regarding the incidence of AKI according to either KIDIGO criteria or by the increase of serum CysC (P =0.116 and P =0.392, respectively). Moreover, a 46.99% increase in CysC level was observed among patients with AKI during the first 24 hours after the procedure, while at the same interval, it increased only 16.01% in patients without AKI.

Conclusion: RIPC with three cycles of 5-minute ischemia and 5-minute reperfusion, did not decrease serum CysC based CI-AKI or alter renal biomarkers course in patients with low risk, who underwent coronary angiography.

Keywords: Contrast-induced nephropathy, Coronary angiography, serum cystatin C, Acute kidney injury, Ischemic preconditioning, Preconditioning

Implication for health policy/practice/research/medical education:

According to our study, the three-cycle preconditioning approach did not decrease cystatin C (CysC) based contrast-induced acute kidney injury (CI-AKI) in 140 low-risk patients undergoing coronary angiography. Furthermore, CysC appears as a proper early biomarker for diagnosis of contrast-induced nephropathy, 24 hours after contrast media administration.

Please cite this paper as: Moradkhani A, Samimagham HR, Tamaddondar M, Farshidi H, Khayatian M, Soleimani S. The efficiency of remote ischemic preconditioning on serum cystatin C-based acute kidney injury in patients undergoing coronary angiography; a randomized controlled trial. J Nephropharmacol. 2021;10(1):09. DOI: 10.34172/npj.2021.09.

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