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. 2018 Sep 4;19(1):473.
doi: 10.1186/s13063-018-2820-3.

The effect of remote ischemic preconditioning on serum creatinine in patients undergoing partial nephrectomy: a study protocol for a randomized controlled trial

Min Hur  1 , Sun-Kyung Park  1 , Jungho Shin  1 , Jung-Yoon Choi  1 , Seokha Yoo  1 , Won Ho Kim  2 , Jin-Tae Kim  1
Affiliations

The effect of remote ischemic preconditioning on serum creatinine in patients undergoing partial nephrectomy: a study protocol for a randomized controlled trial

Min Hur et al. Trials. .

Abstract

Background: Acute kidney injury (AKI) may develop during partial nephrectomy due to ischemic reperfusion injury induced by renal artery clamping or surgical insult. The effect of remote ischemic preconditioning (RIPC) on reducing the renal injury after partial nephrectomy has not been evaluated in terms of urinary biomarkers.

Methods/design: We will conduct a randomized controlled trial enrolling the patients who will undergo partial nephrectomy. In the study group, RIPC which consisted of four 5-min cycles of limb ischemia and reperfusion will be conducted after induction of anesthesia. Postoperative serum creatinine values, the incidence of AKI, and urinary biomarkers, including urinary creatinine, microalbumin, β-2 microglobulin, and N-acetyl-beta-D-glucosaminidase, will be compared between groups during the postoperative 2 weeks. Regional oxygen saturation on the skin of the contralateral kidney will be measured to evaluate the association between intraoperative regional oxygen saturation values and renal injury of the operating side.

Discussion: We expect that our trial may demonstrate the effect of RIPC on mitigating the immediate postoperative renal injury and improving patient outcomes after partial nephrectomy. Moreover, our patients will undergo 99mTc-DTPA radionuclide scintigraphy to calculate glomerular filtration rate 6 and 12 months after surgery. This data should show the long-term effect of RIPC.

Trial registration: ClinicalTrials.gov, ID: NCT03273751 . Registered on 6 September 2017.

Keywords: Acute kidney injury; Partial nephrectomy; Remote ischemic preconditioning; Urinary biomarker.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Seoul National University Institutional Review Boards (approval number: 1707–087-870, protocol version 2.1) and is registered at http://www.clinicaltrials.gov (NCT03273751). Written informed consent from parents is obtained for every study participant.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Figure for the present study
Fig. 2
Fig. 2
Flow diagram of measurements in the study. sCr serum creatinine, eGFR estimated glomerular filtration rate, Hb hemoglobin, RIPC remote ischemic preconditioning, I  ischemia, R  reperfusion, rSO2 regional oxygen saturation, PACU post-anesthesia care unit. Urinary biomarkers, including urinary creatinine, microalbumin, β-2 microglobulin, and N-acetyl-beta-D-glucosaminidase will be measured
See this image and copyright information in PMC

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