Cargando…
Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial
BACKGROUND: Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is an important cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937541/ https://www.ncbi.nlm.nih.gov/pubmed/24292557 http://dx.doi.org/10.1007/s00392-013-0637-3 |
_version_ | 1782305514354376704 |
---|---|
author | Bell, Robert M. Rear, Roger Cunningham, John Dawnay, Anne Yellon, Derek M. |
author_facet | Bell, Robert M. Rear, Roger Cunningham, John Dawnay, Anne Yellon, Derek M. |
author_sort | Bell, Robert M. |
collection | PubMed |
description | BACKGROUND: Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is an important cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to mitigate the risk of CIN, there remains a need for an effective intervention. Remote ischaemic conditioning (RIC), where non-injurious ischaemia is applied to an arm prior to the administration of contrast, has shown promise in attenuating CIN but its effectiveness in preserving long-term renal function is unknown, which will be studied as part of the effect of remote ischaemic conditioning against contrast-induced nephropathy (ERICCIN) trial. (http://Controlled-trials.com Identifier: ISRCTN49645414.) METHODS: The ERICCIN trial is a single-centre, randomised double-blinded placebo-controlled trial which plans to recruit 362 patients who are at risk of CIN, defined by pre-existent renal impairment (estimated glomerular filtration rate <60 ml/min/1.73 m(2)), over a period of 2 years. Patients will be randomised to either control or RIC consisting of 4, 5 min 200 mmHg balloon-cuff inflation/deflations, to the upper arm. The primary endpoint will be the development of CIN (>25 % of eGFR, or rise of creatinine of >44 μmol/l) at 48 h. A key secondary endpoint will be whether RIC impacts upon persistent renal impairment over the 3-month follow-up period. Additional secondary endpoints include the measurement of serum neutrophil gelatinase-associated lipocalin and urinary albumin at 6, 48 h and 3 months following administration of contrast. IMPLICATIONS: Findings from ERICCIN trial will potentially demonstrate that RIC attenuates contrast-induced acute and chronic kidney injury and influence future clinical practice guidelines in at-risk patients undergoing coronary angiographic procedures. |
format | Online Article Text |
id | pubmed-3937541 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-39375412014-03-06 Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial Bell, Robert M. Rear, Roger Cunningham, John Dawnay, Anne Yellon, Derek M. Clin Res Cardiol Original Paper BACKGROUND: Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is an important cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to mitigate the risk of CIN, there remains a need for an effective intervention. Remote ischaemic conditioning (RIC), where non-injurious ischaemia is applied to an arm prior to the administration of contrast, has shown promise in attenuating CIN but its effectiveness in preserving long-term renal function is unknown, which will be studied as part of the effect of remote ischaemic conditioning against contrast-induced nephropathy (ERICCIN) trial. (http://Controlled-trials.com Identifier: ISRCTN49645414.) METHODS: The ERICCIN trial is a single-centre, randomised double-blinded placebo-controlled trial which plans to recruit 362 patients who are at risk of CIN, defined by pre-existent renal impairment (estimated glomerular filtration rate <60 ml/min/1.73 m(2)), over a period of 2 years. Patients will be randomised to either control or RIC consisting of 4, 5 min 200 mmHg balloon-cuff inflation/deflations, to the upper arm. The primary endpoint will be the development of CIN (>25 % of eGFR, or rise of creatinine of >44 μmol/l) at 48 h. A key secondary endpoint will be whether RIC impacts upon persistent renal impairment over the 3-month follow-up period. Additional secondary endpoints include the measurement of serum neutrophil gelatinase-associated lipocalin and urinary albumin at 6, 48 h and 3 months following administration of contrast. IMPLICATIONS: Findings from ERICCIN trial will potentially demonstrate that RIC attenuates contrast-induced acute and chronic kidney injury and influence future clinical practice guidelines in at-risk patients undergoing coronary angiographic procedures. Springer Berlin Heidelberg 2013-11-29 2014 /pmc/articles/PMC3937541/ /pubmed/24292557 http://dx.doi.org/10.1007/s00392-013-0637-3 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Paper Bell, Robert M. Rear, Roger Cunningham, John Dawnay, Anne Yellon, Derek M. Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
title | Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
title_full | Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
title_fullStr | Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
title_full_unstemmed | Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
title_short | Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
title_sort | effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ericcin): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937541/ https://www.ncbi.nlm.nih.gov/pubmed/24292557 http://dx.doi.org/10.1007/s00392-013-0637-3 |
work_keys_str_mv | AT bellrobertm effectofremoteischaemicconditioningoncontrastinducednephropathyinpatientsundergoingelectivecoronaryangiographyericcinrationaleandstudydesignofarandomisedsinglecentredoubleblindplacebocontrolledtrial AT rearroger effectofremoteischaemicconditioningoncontrastinducednephropathyinpatientsundergoingelectivecoronaryangiographyericcinrationaleandstudydesignofarandomisedsinglecentredoubleblindplacebocontrolledtrial AT cunninghamjohn effectofremoteischaemicconditioningoncontrastinducednephropathyinpatientsundergoingelectivecoronaryangiographyericcinrationaleandstudydesignofarandomisedsinglecentredoubleblindplacebocontrolledtrial AT dawnayanne effectofremoteischaemicconditioningoncontrastinducednephropathyinpatientsundergoingelectivecoronaryangiographyericcinrationaleandstudydesignofarandomisedsinglecentredoubleblindplacebocontrolledtrial AT yellonderekm effectofremoteischaemicconditioningoncontrastinducednephropathyinpatientsundergoingelectivecoronaryangiographyericcinrationaleandstudydesignofarandomisedsinglecentredoubleblindplacebocontrolledtrial |