Prevention of contrast-induced nephropathy by limb ischemic preconditioning: Underlying mechanisms and clinical effects.

Prevention of contrast-induced nephropathy by limb ischemic preconditioning: Underlying mechanisms and clinical effects. Am J Physiol Renal Physiol. 2017 May 31;:ajprenal.00130.2017 Authors: Dugbartey G, Redington AN Abstract Contrast-induced nephropathy (CIN) is an important complication following diagnostic radiographic imaging and interventional therapy. It results from administration of intravascular iodinated contrast media (CM) and is currently the third most common cause of hospital-acquired acute kidney injury. CIN is associated with increased morbidity, prolonged hospitalization and higher mortality. Although the importance of CIN is widely appreciated, and its occurrence can be mitigated by the use of pre- and post-hydration protocols and low osmolar instead of high osmolar iodine-containing CM, specific prophylactic therapy is lacking. Remote ischemic preconditioning (RIPC), induced through short cycles of ischemia/reperfusion applied to the limb, is an intriguing new strategy which has been shown to reduce myocardial infarction size in patients undergoing emergency percutaneous coronary intervention. Furthermore, multiple proof of principle clinical studies have suggested benefit in several other ischemia/reperfusion syndromes, including stroke. Perhaps somewhat surprisingly, RIPC also is emerging as a promising strategy for CIN prevention. In this review, we discuss current clinical and experimental developments regardin...
Source: American Journal of Physiology. Renal Physiology - Category: Physiology Authors: Tags: Am J Physiol Renal Physiol Source Type: research