Effect of Remote Ischaemic Preconditioning on Renal Function in Patients Undergoing Living Donor Kidney Transplantation

Huazhong University of Science and Technology120 enrolled

Overview

The purpose of this study was to investigate whether lower limb ischaemic preconditioning can improve renal function in patients undergoing living donor kidney transplantation

Ischemia reperfusion injury (IRI) induced renal failure after kidney transplantation is a common clinical problem associated with a high morbidity and mortality. To reduce the adverse effects of IRI after organ transplantation various strategies aimed at the different pathophysiological processes of IRI have been investigated. Remote ischemic preconditioning (RIPC) is one such strategy where brief IRI of one organ protects other organs from sustained IRI. Many studies have shown that RIPC protects heart, muscle flaps, stomach, liver, lungs, and kidneys from IRI. RIPC of the limb with a tourniquet is a safe and convenient method of preconditioning organs against IRI. However, the efficacy of RIPC in patients undergoing living donor kidney transplantation need to be established and mechanism of early and late RIPC, such as whether the donor should undergo remote preconditioning or the recipient, need to be investigated.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

120

Conditions

Kidney Diseases Kidney Failure, Chronic Kidney Failure Renal Insufficiency Renal Insufficiency, Chronic Urologic Diseases

Interventions

remote ischaemic preconditioningDEVICE

Remote ischaemic preconditioning consisted of three 5-min cycles of left lower limb ischaemia, which was induced by an automated cuff-inflator placed on the left lower limb and inflated to 300 mm Hg, with an intervening 5 min of reperfusion during which the cuff was deflated.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Subject capable of giving written informed consent, with end-stage kidney disease, who is a suitable candidate for primary kidney transplantation * Living donors * Compatible ABO blood type * PRA \< 20% Exclusion Criteria: * Re-transplant patients * Those with peripheral vascular disease affecting the lower limbs

Locations (1)

Department of Anaesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, China

Outcomes

Primary Outcomes

Plasma Creatine Concentration of the Recipients

Plasma creatinine concentration before surgery, 1hour, 4hours, 24hours, 48hours and 72hours after the artery unclamping

Time frame: within the first 3days after the operation

Urinary Output of the Recipients Postoperatively

Accumulated urinary output 1hour, 4hours and 24hours after the artery unclamping and the urinary output on the 2nd and 3rd day after the operation

Time frame: within the first 3days after the operation

Plasma Concentration of NGAL in the Recipients

Plasma concentration of neutrophil gelatinase-associated lipocalin (NGAL) before the operation and 24hours after the artery unclamping

Time frame: within the first 24hours after the operation

Secondary Outcomes

Acute Rejection of Transplanted Kidney

biopsy-confirmed, clinically symptomatic

Time frame: before discharge

Delayed Graft Function

Delayed Graft Function according to the clinical symptoms

Time frame: before discharge

Length of Postoperative Hospital Stay

time from the day of operation to the day of discharge for the recipients

Time frame: before discharge

Total Costs During the Hospitalization

Total costs from the admission to the discharge of the recipients

Time frame: from the admission to the discharge of the patients

Data from ClinicalTrials.gov

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