Remote Preconditioning Might Protect the Kidney in Heart Surgery
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Date
2018
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Abstract
Objective: There are conflicting results about renoprotectiveeffects of remote ischemic preconditioning(RIPC) reported in previous studies. This study is designedto investigate the effects of this application on renalfunction by means of certain deliberate biomarkersduring the early postoperative period in patients undergoingcoronary artery bypass graft (CABG) surgery.Material and Methods: This prospective, randomized,and blinded study was performed in patients who underwentisolated CABG surgery together with cardiopulmonarybypass (CPB) after eliminating factors thatmay confound biomarkers that indicate renal ischemiareperfusioninjury. The authors randomly assignedpatients to RIPC to the left lower extremity using aninflated (study group) or deflated (control group). bloodpressure cuff. Renal functions were analyzed by measuringcystatin C, neutrophil gelatinase-associated lipocalin(NGAL) and creatinine levels at 3 different timepoints namely 1 hour (T1) after CPB and 6 hours (T2)after skin closure, and 24 hours postoperatively (T3).Results: There were no differences between the two groupsin terms of demographic values and the hemodynamicparameters. Plasma cystatin C and creatinin levelswere significantly higher in the control group than thoseof the study group at all time points. Plasma NGALlevels were higher in the control group than in the studygroup at two time points, p=0,001 for time; p=0,243 forgroup respectively.Conclusion: In low risk patients with on- pump CABGsurgery, RIPC seems to protect renal functions. Furtherstudies with different risk groups should also be plannedto determine whether this procedure is useful incardiac surgery patients.