P65 REMOTE ISCHAEMIC PRECONDITIONING REDUCES KIDNEY INJURY IN VASCULAR SURGERY

Teele Kepler; Karl Kuusik; Urmas Lepner; Joel Starkopf; Mihkel Zilmer; Jaan Eha; Liisi Anette Torop; Jaak Kals

doi:10.1016/j.artres.2018.10.118

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Volume 24, Issue C, December 2018, Pages 97 - 97

P65 REMOTE ISCHAEMIC PRECONDITIONING REDUCES KIDNEY INJURY IN VASCULAR SURGERY

Authors

Teele Kepler¹, Karl Kuusik², Urmas Lepner³, Joel Starkopf⁴, Mihkel Zilmer⁵, Jaan Eha², Liisi Anette Torop⁶, Jaak Kals³^{, 5}

¹Department of Surgery, Institute of Clinical Medicine, University of Tartu, Estonia

²Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Estonia

³Department of Surgery, Institute of Clinical Medicine, University of Tartu, Estonia

⁴Department of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, University of Tartu, Estonia

⁵Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia

⁶Department of Neurology, Institute of Clinical Medicine, University of Tartu, Estonia

Available Online 4 December 2018.

DOI: 10.1016/j.artres.2018.10.118 How to use a DOI?
Abstract: Background: Perioperative acute kidney injury has been found to occur in 12% of patients undergoing lower limb revascularisation (Arora et al., 2013). The aim of the current double-blinded, randomised and sham-controlled pilot study was to determine the effect of remote ischaemic preconditioning (RIPC) in perioperative renal damage in vascular surgery.

Methods: Patients undergoing elective lower limb revascularisation surgery between January 2016 and February 2018, who gave full informed consent, were recruited. Four episodes of 5 minutes of upper limb ischaemia were performed preoperatively. In the sham group, pressure equal to venous pressure was applied instead of ischaemia. Blood samples were collected preoperatively and 20–28 hours after surgery.

Results: Twenty-nine patients were enrolled in the sham and 28 patients were enrolled in the experimental group. The baseline characteristics did not differ between the groups except for gender (Table). The surgery resulted in significant increase of creatinine (from the median value of 80 to 88, p = 0.0279) in the sham group. In the RIPC group, in contrast, significant decline in creatinine (from the mean value of 79 to 75, p = 0.034) and cystatin C (from the median value of 1.1 to 0.9, p = 0.0007) was noted. However, changes in creatinine, urea, cystatin C and B2M between the groups were statistically significant (p-values 0.002, 0.0203, 0.0113, 0.0286 respectively) (Figure).

Conclusion: This pilot study demonstrates that RIPC reduces the levels of biomarkers of acute kidney injury in patients undergoing surgical lower limb revascularisation. This phenomenon may offer renoprotection during vascular surgery.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 24 - C
Pages: 97 - 97
Publication Date: 2018/12/04
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2018.10.118 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Cite this article

ris enw bib

TY  - JOUR
AU  - Teele Kepler
AU  - Karl Kuusik
AU  - Urmas Lepner
AU  - Joel Starkopf
AU  - Mihkel Zilmer
AU  - Jaan Eha
AU  - Liisi Anette Torop
AU  - Jaak Kals
PY  - 2018
DA  - 2018/12/04
TI  - P65 REMOTE ISCHAEMIC PRECONDITIONING REDUCES KIDNEY INJURY IN VASCULAR SURGERY
JO  - Artery Research
SP  - 97
EP  - 97
VL  - 24
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2018.10.118
DO  - 10.1016/j.artres.2018.10.118
ID  - Kepler2018
ER  -

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