Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Renal injury

Preventing organ dysfunction — is preconditioning still an option?

Over the past decade remote ischaemic preconditioning (RIPC) has evolved as a promising strategy to reduce ischaemia in remote organs. Although previous studies using surrogate outcomes have encouraged further investigation, two recent randomized controlled trials — the ERICCA trial and the RIPHeart Study — were unable to detect a protective effect of RIPC.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Hausenloy, D. J. et al. Effect of remote ischaemic preconditioning on myocardial injury in patients undergoing coronary artery bypass graft surgery: a randomised controlled trial. Lancet 370, 575–579 (2007).

    Article  Google Scholar 

  2. Zimmerman, R. F. et al. Ischemic preconditioning at a remote site prevents acute kidney injury in patients following cardiac surgery. Kidney Int. 80, 861–867 (2011).

    Article  Google Scholar 

  3. Healy, D. A. et al. Remote preconditioning and major clinical complications following adult cardiovascular surgery: systematic review and meta-analysis. Int. J. Cardiol. 176, 20–31 (2014).

    Article  CAS  Google Scholar 

  4. Meybohm, P. et al. A multicenter trial of remote ischemic preconditioning for heart surgery. N. Engl. J. Med. 373, 1397–1407 (2015).

    Article  CAS  Google Scholar 

  5. Hausenloy, D. J. et al. Remote ischemic preconditioning and outcomes of cardiac surgery. N. Engl. J. Med. 373, 1408–1417 (2015).

    Article  CAS  Google Scholar 

  6. Yoo, Y. C., Shim, J. K., Song, Y., Yang, S. Y. & Kwak, Y. L. Anesthetics influence the incidence of acute kidney injury following valvular heart surgery. Kidney Int. 86, 414–422 (2014).

    Article  CAS  Google Scholar 

  7. Leite, T. T., Macedo, E., Martins, I. D., Neves, F. M. & Libório, A. B. Renal outcomes in critically ill patients receiving propofol or midazolam. Clin. J. Am. Soc. Nephrol. 10, 1937–1945 (2015).

    Article  CAS  Google Scholar 

  8. Choi, Y. S. et al. Effect of remote ischemic preconditioning on renal dysfunction after complex valvular heart surgery: a randomized controlled trial. J. Thorac. Cardiovasc. Surg. 142, 148–154 (2011).

    Article  Google Scholar 

  9. Yang, Y. et al. Remote ischemic preconditioning for prevention of acute kidney injury: a meta-analysis of randomized controlled trials. Am. J. Kidney Dis. 64, 574–583 (2014).

    Article  Google Scholar 

  10. Zarbock, A. et al. Effect of remote ischemic preconditioning on kidney injury among high-risk patients undergoing cardiac surgery: a randomized clinical trial. JAMA 313, 2133–2141 (2015).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ravindra L. Mehta.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Macedo, E., Mehta, R. Preventing organ dysfunction — is preconditioning still an option?. Nat Rev Nephrol 12, 8–9 (2016). https://doi.org/10.1038/nrneph.2015.192

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2015.192

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing