Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study

Marie B. Nielsen*, Nicoline Krogstrup, Mihai Oltean, Gertrude J. Nieuwenhuijs-Moeke, Frank J. M. F. Dor, Henrik Birn, Bente Jespersen

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

    4 Citaten (Scopus)
    38 Downloads (Pure)

    Samenvatting

    Background

    Ischaemia-reperfusion injury in kidney transplantation leads to delayed graft function (DGF), which is associated with reduced long term graft function. Remote ischaemic conditioning (RIC) improved early kidney graft function in a porcine model of donation after brain death and was associated with improved long-term cardiac outcome after myocardial ischaemia. This randomised, double-blinded trial evaluated the effect of RIC on kidney graft outcome in the first year, and examined the predictive value of a new measure of initial kidney graft function, i.e. the estimated time to a 50% reduction in plasma creatinine post-transplantation (tCr50).

    Methods

    A total of 225 patients undergoing deceased donor kidney transplantation were randomised to RIC or a sham procedure performed prior to kidney reperfusion. Up to four repetitive cycles of five minutes of leg ischaemia and five minutes of reperfusion were given. GFR, plasma creatinine, cystatin C and neutrophil gelatinase associated lipocalin (NGAL) were measured at three and twelve months and estimated GFR was calculated using four different equations. Other secondary outcomes were identified from patient files.

    Results

    RIC did not affect GFR or other outcomes when compared to the sham procedure at three or twelve months. tCr50 correlated with one year graft function (p

    Conclusion

    RIC during deceased donor kidney transplantation did not improve one year outcome. However, tCr50 may be a relevant marker for studies aiming to improve graft onset.

    Originele taal-2English
    Artikelnummer0226882
    Aantal pagina's10
    TijdschriftPLoS ONE
    Volume14
    Nummer van het tijdschrift12
    DOI's
    StatusPublished - 30-dec-2019

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