Remote ischemic preconditioning to reduce contrast-induced nephropathy: study protocol for a randomized controlled trialReport as inadecuate

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, 15:119

First Online: 11 April 2014Received: 10 September 2013Accepted: 01 April 2014DOI: 10.1186-1745-6215-15-119

Cite this article as: Sterenborg, T.B., Menting, T.P., de Waal, Y. et al. Trials 2014 15: 119. doi:10.1186-1745-6215-15-119


BackgroundDespite the increasing use of pre- and posthydration protocols and low-osmolar instead of high-osmolar iodine-containing contrast media, the incidence of contrast-induced nephropathy CIN is still significant. There is evidence that contrast media cause ischemia-reperfusion injury of the medulla. Remote ischemic preconditioning RIPC is a non-invasive, safe, and low-cost method to reduce ischemia-reperfusion injury.

MethodsThe RIPCIN study is a multicenter, single-blinded, randomized controlled trial in which 76 patients at risk of CIN will receive standard hydration combined with RIPC or hydration with sham preconditioning. RIPC will be applied by four cycles of 5 min ischemia and 5 min reperfusion of the forearm by inflating a blood pressure cuff at 50 mmHg above the actual systolic pressure. The primary outcome measure will be the change in serum creatinine from baseline to 48 to 72 h after contrast administration.

DiscussionA recent pilot study reported that RIPC reduced the incidence of CIN after coronary angioplasty. The unusual high incidence of CIN in this study is of concern and limits its generalizability. Therefore, we propose a randomized controlled trial to study whether RIPC reduces contrast-induced kidney injury in patients at risk for CIN according to the Dutch guidelines.

Trial registrationCurrent Controlled Trials ISRCTN76496973

KeywordsContrast-induced nephropathy Remote ischemic preconditioning Acute kidney injury Pre- and posthydration Randomized controlled trial AbbreviationsCINContrast-induced nephropathy

MDRDMean glomerular filtration rate

RIPCRemote ischemic preconditioning.

Electronic supplementary materialThe online version of this article doi:10.1186-1745-6215-15-119 contains supplementary material, which is available to authorized users.

Thomas B Sterenborg, Theo P Menting contributed equally to this work.

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Author: Thomas B Sterenborg - Theo P Menting - Yvonne de Waal - Rogier Donders - Kimberley E Wever - M Susan Lemson - Daan JA 


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