Background
The incidence AQ4 of acute kidney injury (AKI) is ∼21.6% in hospitalized patients with an
increased incidence of mortality. Although many trials have been done to prevent or
treat AKI, most of these efforts have yielded limited success.
Objectives
This study aimed to detect the effects of remote ischemic preconditioning (RIPC) on
the incidence and outcomes of AKI.
Study design
A meta-analysis was used to address this concern.
Settings
A meta-analysis-based study following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted.
Methods
The databases such as MEDLINE, EMBASE, PubMed, and Cochrane were
systemically searched to identify all published prospective, randomized, and
controlled clinical trials in the last 5 years comparing RIPC with control in
different procedures.
Results
A total of 26 studies were identified for inclusion in this study, involving 3978
patients. The risk of bias was low. Meta-analysis showed that the rate of AKI was
significantly lower in the RIPC group, there was no statistically significant difference
in the overall mortality, and there was no significant change in serum creatinine
value. Regarding serum neutrophil gelatinase-associated lipocalin and estimated
glomerular filtration rate, the study favors the RIPC group than the control group.
There was no significant difference in the period of hospital stays, whereas the
length of ICU stay was remarkably reduced in the RIPC group.
Limitations
The definitions of AKI adopted in respective trials were different. Comorbidities
among the studies that may raise protective threshold were different. In our
analysis, preoperative kidney function of the studies was different, and the use
of different anesthetic protocols might confound the effect of RIPC.
Conclusion
RIPC offers a novel, noninvasive, and inexpensive treatment strategy for
decreasing AKI incidence and improving the outcome in high-risk patients |
