The role of remote ischemic preconditioning in preventing contrast-induced nephropathy following invasive coronary angiography; a randomized controlled trial

Introduction: Remote ischemic preconditioning (RIPC) is now proposed as an effective approach for preventing contrast-induced nephropathy (CIN); however, the results on its efficacy have already remained uncertain. Objectives: We aimed to assess the beneficial effects of RIPC in preventing CIN in patients undergoing coronary angiography (CA) followed by angioplasty. Patients and Methods: One hundred patients candidate for elective CA and coronary angioplasty, moderate to high risk for CIN were randomized into two groups including the group which planned for RIPC, and the control group. The overall prevalence rate of CIN was assessed and compared across the two groups. Results: The two groups were matched for demographics, cardiovascular risk profiles and laboratory parameters. The prevalence of CIN in RIPC group was 14.0% and in the control group was 26.0% indicating no statistical difference between the two groups (P = 0.105). Requiring dialysis was also planned for 0.0% and 2.0% respectively with no difference (P = 0.500). Conclusion: RIPC may not prevent CIN in patients who are candidate for invasive CA. Trial Registration: The study was approved in the Iranian Registry of Clinical Trials (identifier: IRCT20171230038144N1; https://www.irct.ir/trial/28715, ethical code: IR.IUMS. FMD.REC 1396.9311171014).