Effect of Remote Ischaemic preConditioning on CIN
Research type
Research Study
Full title
A single centre double-blinded randomised placebo controlled study investigating the Effect of Remote Ischaemic preConditioning on Contrast medium Induced Nephropathy in at-risk patients undergoing coronary angiography or PCI. (ERICCIN)
IRAS ID
121326
Contact name
Derek Yellon
Contact email
Sponsor organisation
UCL
Research summary
The objective of this study is to investigate whether a novel intervention called ’Remote Ischaemic Preconditioning’ can reduce the incidence of contrast nephropathy, an acute kidney injury caused by the contrast medium that is used during routine coronary angiography and angioplasty. It is thought that the contrast medium damages the kidney by a reducing kidney blood flow as well as by a direct toxic effect. It is known that preexistant kidney dysfunction is the main pre procedure risk factor for contrast induced kidney injury along with a number of other factors such as age over 75, diabetes, anaemia and heart failure.
Remote ischaemic preconditioning is a new concept which involves repeated inflation of a blood pressure cuff on the upper arm or leg to cause reduced blood flow and a local oxygen deficit (ischaemia) in the arm or leg tissue. It is thought that the ’ischaemic’ tissues release pro survival proteins which also protect other organs in the body from reduced blood flow. Several studies have shown a protective effect in a number of situations including during heart attacks and heart surgery.
Suitable participants awaiting coronary angiography or angioplasty who have impaired kidney function will be stratified into high, medium and low risk groups and then randomly assigned in blocks to receive either the ’remote ischaemic preconditioning’ treatment or a placebo. They will then undergo their coronary angiogram or angioplasty with the standard measures taken to reduce the risk of an acute kidney injury. We will take blood and urine tests prior to and after the procedure to assess whether the treatment has been effective in preventing damage to the patients’ kidneys. We will then follow up the patients at three months to assess whether there has been any persistent kidney injury or other cardiovascular events.
REC name
London - Queen Square Research Ethics Committee
REC reference
13/LO/0502
Date of REC Opinion
4 Jun 2013
REC opinion
Further Information Favourable Opinion