Background and Aims:
Remote ischaemic preconditioning (RIPC) of short cycles of distant tissue ischaemia followed by reperfusion is a promising technique to reduce tissue damage from ischaemia-reperfusion injury. The aim of the current double-blinded, randomised and sham-controlled pilot study was to determine the effect of RIPC in perioperative renal damage in vascular surgery.
Methods:
Patients undergoing elective lower limb revascularisation surgery between January 2016 and February 2018 were recruited. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia was applied. Blood samples were collected preoperatively and 20─28 hours after surgery for assessement of biomarkers of acute kidney injury.
Results
Twenty-eight patients were enrolled both in the sham and in the experimental group. In the experimental group the surgery ( resulted in significant increase of creatinine (from the median value of 80 to 88, p= 0.0279) and trends toward increases in urea, cystatin C and beta-2-microglobulin (p=n.s., data not shown) in the sham group. In contrast, in the RIPC group 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) together with trends towards to reduction in urea and beta-2-microglobulin (p=n.s., data not shown) was noted. Changes in creatinine, urea, cystatin C and beta-2-microglobulin between the groups were statistically significant (p-values 0.002, 0.0203, 0.0113, 0.0286 respectively).
Conclusions:
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.

03 - REMOTE ISCHAEMIC PRECONDITIONING ATTENUATES KIDNEY INJURY PERIOPERATIVELY IN PATIENTS UNDERGOING SURGICAL LOWER LIMB REVASCULARISATION: RESULTS FROM A RANDOMIZED DOUBLE-BLINDED CONTROLLED TRIAL