Abstract
BackgroundAcute kidney injury (AKI) may develop during partial nephrectomy due to ischemic reperfusion injury induced by renal artery clamping or surgical insult. The effect of remote ischemic preconditioning (RIPC) on reducing the renal injury after partial nephrectomy has not been evaluated in terms of urinary biomarkers.Methods/designWe will conduct a randomized controlled trial enrolling the patients who will undergo partial nephrectomy. In the study group, RIPC which consisted of four 5-min cycles of limb ischemia and reperfusion will be conducted after induction of anesthesia. Postoperative serum creatinine values, the incidence of AKI, and urinary biomarkers, including urinary creatinine, microalbumin, β-2 microglobulin, and N-acetyl-beta-D-glucosaminidase, will be compared between groups during the postoperative 2 weeks. Regional oxygen saturation on the skin of the contralateral kidney will be measured to evaluate the association between intraoperative regional oxygen saturation values and renal injury of the operating side.DiscussionWe expect that our trial may demonstrate the effect of RIPC on mitigating the immediate postoperative renal injury and improving patient outcomes after partial nephrectomy. Moreover, our patients will undergo 99mTc-DTPA radionuclide scintigraphy to calculate glomerular filtration rate 6 and 12 months after surgery. This data should show the long-term effect of RIPC.Trial registrationClinicalTrials.gov, ID: NCT03273751. Registered on 6 September 2017.
Highlights
Acute kidney injury (AKI) may develop during partial nephrectomy due to ischemic reperfusion injury induced by renal artery clamping or surgical insult
The present study will test the hypothesis that remote ischemic preconditioning (RIPC) performed during partial nephrectomy will reduce the ischemia-reperfusion injury (IRI) caused by renal artery clamping during surgery as well as the surgical insult
Our study should be able to give a reliable answer to the question of whether RIPC could protect the kidney from IRI during partial nephrectomy
Summary
Acute kidney injury (AKI) may develop during partial nephrectomy due to ischemic reperfusion injury induced by renal artery clamping or surgical insult. The effect of remote ischemic preconditioning (RIPC) on reducing the renal injury after partial nephrectomy has not been evaluated in terms of urinary biomarkers. Remote ischemic preconditioning (RIPC) refers to applying one or more cycles of brief, non-lethal ischemia and reperfusion to a distant organ or tissue, which is known to protect heart and other organs against acute ischemic insult [1,2,3,4]. The incidence of postoperative AKI and chronic kidney disease were significantly lower after partial nephrectomy compared to radical nephrectomy [11,12,13]. During partial nephrectomy, the renal vascular pedicle usually needs to be temporarily clamped, leading to ischemia-reperfusion injury (IRI). AKI after partial nephrectomy still occurs frequently due to IRI and the incidence of AKI after partial nephrectomy has been reported to be as high as 39% [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
