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Contrast-induced nephropathy (CIN) is the acute deterioration of renal function after parenteral administration of radio contrast media in the absence of other causes. The true incidence of CIN is difficult to assess because of differences among the various published studies in the definition of CIN, the proportion of high-risk patients, the types of contrast media, and the use of preventive measures. Remote ischemic preconditioning (IPC) may offer a novel, nonpharmacological prevention strategy for lowering CI-AKI incidence in patients undergoing CA. It is assumed that IPC procures protective effects on tissue or organ by multiple brief cycles of ischemia and reperfusion applied to another remote tissue or organ. This simple technique can be used in all medical centers worldwide.
To investigate the effect of ischemic preconditioning in prevention of CIN in patients with renal impairment undergoing percutaneous coronary angiography.
In this study, 100 patients undergoing PCI with base line creatinine clearance < 60mg/dl were studied. Patients were divided into 2 groups (ischemic preconditioning group and control group), 50 patients in each group. The incidence of CIN was markedly lower in ischemic preconditioning group 14% VS 38% in control group.The incidence of CIN difference as was found to be (24%). amount of dye used., decreased LVEF and presence of significant LAD lesion was significant risk factors for occurrence of CIN.
The current study proved that remote ischemic preconditioning plays an important role in prevention of CIN in patients undergoing PCI with renal impairment GFR < 60 mg/ dl. amount of contrast, decreased LVEF, and presence of LAD significant lesion were significant risk factors for developing of CIN and these subgroups benefited from application of ischemic preconditioning.