Background: In a multicenter, rando

背景：在一项多中心随机试验中，研究人员招募了急性肾损伤高危患者，这是由<br>克利夫兰诊所基金会评分为6或更高确定的。作者在四家医院招募了240名患者，并将他们随机分配至远程<br>缺血预处理或对照。作者发现，远程缺血预处理可以减少<br>接受心脏手术的高危患者的急性肾损伤。现在，作者报告了远程缺血预处理对90天结局的影响。<br>方法：在RenalRIP试验的后续研究中，作者检查了远程缺血预处理的作用<br>在复合终点上，主要的不良肾脏事件包括死亡率，需要进行肾脏替代治疗和在90天时持续的肾功能不全。次要结果是<br>急性肾损伤患者的持续性肾功能不全和透析依赖性。<br>结果：<br>相对于对照组（120 天中的30天[25.0％]），远程缺血预处理在90天时显着减少了主要不良肾脏事件的发生率（120 天中的30天[14.2％]）；绝对危险度降低了10.8％； 95％CI为0.9至0.9。 20.8％； P = 0.034）。在<br>心脏手术后出现急性肾损伤的患者中，远程缺血预处理组的38名受试者中有2名（5.3％），对照组的56名受试者中有13名（23.2％）在90天时未恢复肾功能（绝对风险<br>减少17.9％；95％CI，4.8至31.1％; P = 0.020）。<br>与未达到主要不良肾脏事件终点的患者相比，急性肾损伤生物标记物也有所增加。<br>结论：远程缺血预处理显着降低了复合终点终点主要<br>不良肾脏事件在3个月内的发生率，这些不良事件包括死亡率，需要肾脏替代治疗以及<br>在进行心脏手术的高危患者中持续存在的肾功能不全。此外，远程缺血预处理可改善<br>急性肾损伤患者的肾脏恢复。

Background: In a multicenter, randomized trial, the authors enrolled patients at high-risk for acute kidney injury as identified by a <br>Cleveland Clinic Foundation score of 6 or more. The authors enrolled 240 patients at four hospitals and randomized them to remote <br>ischemic preconditioning or control. The authors found that remote ischemic preconditioning reduced acute kidney injury in high-risk <br>patients undergoing cardiac surgery. The authors now report on the effects of remote ischemic preconditioning on 90-day outcomes.<br>Methods: In this follow-up study of the RenalRIP trial, the authors examined the effect of remote ischemic preconditioning <br>on the composite endpoint major adverse kidney events consisting of mortality, need for renal replacement therapy, and persistent renal dysfunction at 90 days. Secondary outcomes were persistent renal dysfunction and dialysis dependence in patients <br>with acute kidney injury.<br>Results: Remote ischemic preconditioning significantly reduced the occurrence of major adverse kidney events at 90 days (17 <br>of 120 [14.2%]) versus control (30 of 120 [25.0%]; absolute risk reduction, 10.8%; 95% CI, 0.9 to 20.8%; P = 0.034). In <br>those patients who developed acute kidney injury after cardiac surgery, 2 of 38 subjects in the remote ischemic preconditioning group (5.3%) and 13 of 56 subjects in the control group (23.2%) failed to recover renal function at 90 days (absolute risk <br>reduction, 17.9%; 95% CI, 4.8 to 31.1%; P = 0.020). Acute kidney injury biomarkers were also increased in patients reaching <br>the major adverse kidney event endpoint compared to patients who did not.<br>Conclusions: Remote ischemic preconditioning significantly reduced the 3-month incidence of a composite endpoint major <br>adverse kidney events consisting of mortality, need for renal replacement therapy, and persistent renal dysfunction in high-risk <br>patients undergoing cardiac surgery. Furthermore, remote ischemic preconditioning enhanced renal recovery in patients with <br>acute kidney injury.

背景：在一项多中心、随机试验中，作者将急性肾损伤高危患者纳入研究<br>克利夫兰诊所基金会得分6分或以上。作者在四家医院登记了240名患者，并将他们随机分配到远程医疗中心<br>缺血预处理或对照。作者发现远程缺血预处理可减轻高危人群的急性肾损伤<br>接受心脏手术的病人。作者现在报道了远程缺血预处理对90天预后的影响。<br>方法：在RenalRIP试验的随访研究中，作者检查了远程缺血预处理的效果<br>在复合终点，主要的肾脏不良事件包括死亡率、肾脏替代治疗的需要和90天时的持续性肾功能不全。次要结果为持续性肾功能不全和透析依赖<br>急性肾损伤。<br>结果：远程缺血预处理可显著减少90天时主要肾脏不良事件的发生（17<br>与对照组相比（120例中的30例[25.0%]；绝对风险降低10.8%；95%可信区间0.9-20.8%；P=0.034）。在<br>急性预处理组23例（2.3%）肾功能衰竭（2.3%）为缺血预处理组（2.3%）<br>降低，17.9%；95%可信区间，4.8至31.1%；P=0.020）。急性肾损伤患者的生物标志物也增加<br>主要肾脏不良事件终点与未发生的患者比较。<br>结论：远程缺血预处理显著降低了复合终点3个月的发生率<br>肾脏不良事件包括死亡率、肾脏替代治疗的需要和高危患者的持续性肾功能不全<br>接受心脏手术的病人。此外，远程缺血预处理可促进肾功能恢复<br>急性肾损伤。<br>