Remote Ischemic Preconditioning (RIPC) And Ischemic Acute Tubular Necrosis

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Acute kidney injury (AKI) due to ischemic acute tubular necrosis (ATN) typically lasts 7 to 21 days, with most patients returning to or near their previous baseline level of renal function as the necrotic tubular cells regenerate. Remote ischemic preconditioning (RIPC) is a minimally invasive procedure by which the deliberate induction of transient, nonlethal ischemia of an organ protects against subsequent ischemic injury of another organ. Numerous clinical trials and meta-analyses have examined the effects of RIPC on ischemic acute tubular necrosis (ATN) with conflicting results. A meta-analysis of 28 randomized clinical trials involving over 6500 patients found that RIPC, prior to surgical procedures associated with a high risk of ischemic ATN, had no effect on the serum creatinine, need for dialysis, length of hospital stay, or all-cause mortality.

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