Background - Contrast-medium-induced acute kidney injury is associated with substantial morbidity and mortality. The underlying mechanism has been partially attributed to ischemic kidney injury. The aim of this randomized, double-blind, sham-controlled trial was to assess the impact of remote ischemic preconditioning on contrast-medium-induced acute kidney injury.Methods and Results - Patients with impaired renal function (serum creatinine >1.4 mg/dL and/or estimated glomerular filtration rate