Heart and vessels
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Randomized Controlled Trial
Remote ischemic preconditioning in hemodialysis: a pilot study.
Hemodialysis (HD)-induced myocardial ischemia is associated with an elevated cardiac troponin T, and is common in asymptomatic patients undergoing conventional HD. Remote ischemic preconditioning (RIPC) has a protective effect against myocardial ischemia-reperfusion injury. We hypothesized that RIPC also has a protective effect on HD-induced myocardial injury. ⋯ Demographic and baseline laboratory values were not different between the control (n = 17) and the RIPC groups (n = 17). cTnT levels tended to decrease from day 2 in the RIPC group through to 28 days, in contrast to no change in the control group. There were significant differences in the change of cTnT level at day 28 from baseline [Control, median; -0.002 ng/ml (interquartile range -0.008 to 0.018) versus RIPC, median; -0.015 ng/ml (interquartile range -0.055 to 0.004), P = 0.012]. RIPC reduced cTnT release in chronic conventional HD patients, suggesting that this simple, cheap, safe, and well-tolerated procedure has a protective effect against HD-induced ischemia.