Background: Contrast-induced acute

Background: Contrast-induced acute kidney injury (CI-AKI) is a common cause of hospital-acquired AKIand a serious complication of percutaneous coronary intervention.Objective: The aim of the present study was to assess whether remote ischemic preconditioning (RIPC)reduces the incidence of CI-AKI.Methods: We conducted a prospective, randomized, sham-controlled clinical study. The study included101 patients admitted to the Intensive Cardiac Therapy Clinic of Medical University of Lodz for electivepercutaneous coronary intervention. The participants were randomly assigned in a 1:1 ratio to either acontrol group (n = 51) or an RIPC group (n = 50). In the latter, RIPC was achieved before percutaneouscoronary intervention by 4 cycles of 5-minute inflation of a cuff on the left upper arm to 200 mm Hgfollowed by 5-minute deflation. In the control group, a deflated cuff was placed on the left arm for 40minutes. Serum creatinine concentration was measured to check for the presence of CI-AKI within 48to 72 hours of percutaneous coronary intervention. Serum neutrophil gelatinase-associated lipocalin levelwas also measured within 3 hours.Results: CI-AKI occurred in 2 patients from the RIPC group (4%) and 3 patients from the control group(5.9%), but the difference was not significant (P = 0.98). The patients who developed CI-AKI also demonstrated increased serum neutrophil gelatinase-associated lipocalin concentrations (the area under the receiver operator characteristic curve = 0.97; 95% CI, 0.938–1.00; P < 0.00) and the optimal cutoff pointvalue was 118.9 ng/mL.Conclusions: The use of RIPC before elective percutaneous coronary intervention was not found to preventCI-AKI.

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结果 (简体中文) 1: [复制]

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背景：造影剂引起的急性肾损伤（CI-AKI）是医院获得性AKI的常见原因， 也是经皮冠状动脉介入治疗的严重并发症。 目的：本研究的目的是评估远程缺血预处理（RIPC）是否能 降低CI-AKI的发生率。 方法：我们进行了一项前瞻性，随机，假对照临床研究。该研究包括 101名因选择性 经皮冠状动脉介入治疗而被罗兹医科大学的心脏强化治疗诊所收治的患者。将参与者以1：1的比例随机分配到 对照组（n = 51）或RIPC组（n = 50）。在后者中，RIPC是在经皮之前完成的 冠状动脉介入治疗：左上臂的袖带充气5分钟至200 mm Hg的4个周期， 然后放气5分钟。在对照组中，将放气的袖套放在左臂上40 分钟。测量血清肌酐浓度，以检查 经皮冠状动脉介入治疗后48 至72小时内是否存在CI-AKI 。 还在3小时内测量了血清中性粒细胞明胶酶相关的脂蛋白水平。 结果：RIPC组2例（4％）和对照组3例发生CI-AKI （5.9％），但差异不显着（P = 0.98）。发生CI-AKI的患者还表现出血清中性粒细胞明胶酶相关的脂钙素浓度升高（受体操作者特征曲线下的面积= 0.97； 95％CI，0.938–1.00； P <0.00）和最佳临界点 值为118.9 ng / mL。 结论：在选择性经皮冠状动脉介入治疗之前未使用RIPC可以预防 CI-AKI。

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结果 (简体中文) 2:[复制]

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Background: Contrast-induced acute kidney injury (CI-AKI) is a common cause of hospital-acquired AKI and a serious complication of percutaneous coronary intervention. Objective: The aim of the present study was to assess whether remote ischemic preconditioning (RIPC) reduces the incidence of CI-AKI. Methods: We conducted a prospective, randomized, sham-controlled clinical study. The study included 101 patients admitted to the Intensive Cardiac Therapy Clinic of Medical University of Lodz for elective percutaneous coronary intervention. The participants were randomly assigned in a 1:1 ratio to either a control group (n = 51) or an RIPC group (n = 50). In the latter, RIPC was achieved before percutaneous coronary intervention by 4 cycles of 5-minute inflation of a cuff on the left upper arm to 200 mm Hg followed by 5-minute deflation. In the control group, a deflated cuff was placed on the left arm for 40 minutes. Serum creatinine concentration was measured to check for the presence of CI-AKI within 48 to 72 hours of percutaneous coronary intervention. Serum neutrophil gelatinase-associated lipocalin level was also measured within 3 hours. Results: CI-AKI occurred in 2 patients from the RIPC group (4%) and 3 patients from the control group (5.9%), but the difference was not significant (P = 0.98). The patients who developed CI-AKI also demonstrated increased serum neutrophil gelatinase-associated lipocalin concentrations (the area under the receiver operator characteristic curve = 0.97; 95% CI, 0.938–1.00; P < 0.00) and the optimal cutoff point value was 118.9 ng/mL. Conclusions: The use of RIPC before elective percutaneous coronary intervention was not found to prevent CI-AKI.

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结果 (简体中文) 3:[复制]

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背景：造影剂诱导的急性肾损伤（CI-AKI）是医院获得性AKI的常见原因 以及经皮冠状动脉介入治疗的严重并发症。 目的：本研究的目的是评估远程缺血预处理（RIPC） 降低CI-AKI的发生率。 方法：我们进行了一项前瞻性、随机、假对照的临床研究。研究包括 101例择期入住洛兹医科大学心脏强化治疗门诊 经皮冠状动脉介入治疗。参与者被随机分配到一个1:1的比例 对照组（n=51）或RIPC组（n=50）。后者是在经皮穿刺前达到RIPC 冠状动脉介入治疗4个周期，5分钟后左上臂袖带充气至200毫米汞柱 接下来是5分钟的通货紧缩。对照组在左臂放置放气袖带40次 分钟。测定血清肌酐浓度，以检查48小时内是否存在CI-AKI 到72小时的经皮冠状动脉介入治疗。血清中性粒细胞明胶酶相关脂蛋白水平 也在3小时内进行了测量。 结果：RIPC组2例（4%）发生CI-AKI，对照组3例 （5.9%），但差异不显著（P=0.98）。出现CI-AKI的患者还显示血清中性粒细胞明胶酶相关脂蛋白浓度升高（受体操作员特征曲线下面积=0.97；95%CI，0.938-1.00；P<0.00）和最佳临界点 值为118.9ng/mL。 结论：择期经皮冠状动脉介入治疗术前应用RIPC不能预防 齐阿基。

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