Using remote ischemic conditioning to reduce acute kidney injury in patients undergoing percutaneous coronary intervention: a meta-analysis

Abstract

Background and aims:It remains uncertain whether remote ischemic conditioning (RIC) could prevent acute kidney injury (AKI) in patients undergoing percutaneous coronary intervention (PCI). Thus, this meta-analysis aiming to explore the renoprotective role of RIC in patients undergoing PCI was carried out.Methods:PubMed, Web of Science, and Cochrane Library were searched from inception to 31 December 2014 to identify eligible randomized controlled trials. Pooled risk ratio, mean, standard deviation and 95% CI were used to assess the effect by fixed- or random-effect models. Heterogeneity was assessed by the Cochran Q and I 2 statistics.Results:Nine trials were included in this study. RIC decreased the AKI incidence in patients undergoing PCI compared with control individuals (P < 0.001; RR, 0.53; 95% CI, 0.39–0.71; P for heterogeneity = 0.15; heterogeneity χ2 = 13.38; I2 = 33%). Besides, limb conditioning attenuated AKI (P = 0.001; RR, 0.57; 95% CI, 0.41–0.81; P for heterogeneity = 0.13; heterogeneity χ2 = 12.48; I2 = 36%). Remote postconditioning may reduce the AKI incidence (P = 0.03; RR, 0.65; 95% CI, 0.44–0.97; P for heterogeneity = 0.15; heterogeneity χ2 = 5.36; I2 = 44%); remote preconditioning could also play a renoprotective role (P < 0.001; RR, 0.42; 95% CI, 0.27–0.65; P for heterogeneity = 0.31; heterogeneity χ2 = 5.98; I2 = 16%).Conclusions:RIC may not only confer cardioprotection, but also reduce the incidence of AKI in patients undergoing PCI, ultimately leading to better clinical outcomes. RIC may potentially be a powerful approach conferring protection in patients undergoing PCI in future clinical practice. More large-scale trials are required to obtain a more reliable conclusion.