Efficacy of Remote Ischemic Preconditioning in the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography /Angioplasty

Background: Contrast-induced nephropathy (CIN) is a significant common complication in patients undergoing coronary angiography. This study was carried out to determine the efficacy of remote ischemic preconditioning in the prevention of CIN in patients undergoing coronary angiography/angioplasty. Methods: This randomized controlled trial assessed 171 eligible patients undergoing coronary angiography/angioplasty in Shariati Hospital between May 2018 and June 2019. The patients were randomly assigned to either the remote ischemic preconditioning group or the control group. The glomerular filtration rate (GFR), CIN, and creatinine levels were compared between the groups. Results: The incidence rate of CIN was 1.2% in the intervention group and 9.4% in the control group (P = 0.018), with a risk ratio of 0.125. There were significant improvements in creatinine and GFR in the intervention group (P = 0.007 and P = 0.001, respectively), while there were no meaningful improvements in creatinine and GFR in the control group. The intervention group featured 11 patients in Stage IV chronic kidney disease, none of whom was CIN-positive, whereas the control group had 2 patients in Stage IV, both of whom were CIN-positive (P 0.001). Conclusions: The results showed the efficacy of remote ischemic preconditioning in the prevention of CIN, the reduction of creatinine reduction, and the elevation of GFR in patients undergoing coronary angiography/angioplasty.