Renoprotective effects of remote ischemic preconditioning on acute kidney injury induced by repeated tourniquet application in patients undergoing extremity surgery.
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引用次数: 0
Abstract
Objective: Limb ischemia-reperfusion injury caused by repeated tourniquet application usually leads to acute kidney injury, adversely affecting patient prognosis. This study aimed to investigate the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing extremity surgery with repeated tourniquet application.
Methods: 64 patients were enrolled and randomly divided into an RIPC group and a control group, with 32 patients in each. Pretreatment was administered before surgery, and baseline characteristics were collected. Perioperative surgical characteristics, renal biomarkers, oxidative stress markers, inflammatory factors, and postoperative conditions were recorded.
Results: 2 participant were excluded from each group, leaving 30 patients per group. There were no significant differences between the two groups regarding baseline characteristics and perioperative surgical characteristics (p > 0.05). Compared to the control group, the RIPC group showed a significant decrease in BUN and SCr at 48 h postoperatively (p < 0.05). Levels of Cys-C, [TIMP-2] × [IGFBP-7], KIM-1, IL-18, and NGAL were significantly reduced at the first and second tourniquet releases and at 24 h postoperatively in the RIPC group (p < 0.05). From the first tourniquet release to 48 h postoperatively, MDA levels were significantly lower (p < 0.05) and SOD levels were significantly higher (p < 0.05) in the RIPC group compared to the control group. Postoperative conditions did not differ significantly between the groups.
Conclusion: RIPC effectively mitigated acute kidney injury caused by repeated tourniquet application, offering a robust method for perioperative renal protection in patients undergoing extremity surgery. Future studies should explore the underlying mechanisms and long-term clinical outcomes of RIPC in broader patient populations.
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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