Ho PW, Pang WF, Szeto CC.; Nephrology (Carlton). 2015 Sep 15.
Acute kidney injury (AKI) is a common complication associated with high morbidity and mortality in hospitalized patients. One potential mechanism underlying renal injury is ischemia/reperfusion injury (IRI), which attributed the organ damage to the inflammatory and oxidative stress responses induced by a period of renal ischemia and subsequent reperfusion.
Therapeutic strategies that target at minimizing the effect of IRI on the kidneys may prevent AKI and improve clinical outcomes significantly. In this review, we examine the technique of remote ischemic preconditioning (rIPC), which has been shown by several trials to confer organ protection by applying transient, brief episodes of ischemia at a distant site before a larger ischemic insult. We provide an overview of the current clinical evidence regarding the renoprotective effect of rIPC in the key clinical settings of cardiac or vascular surgery, contrast-induced AKI, pre-existing chronic kidney disease (CKD) and renal transplantation, and discuss key areas for future research.