Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study.
<h4>Background</h4>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...
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226882&type=printable |
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| author | Marie B Nielsen Nicoline V Krogstrup Mihai Oltean Gertrude J Nieuwenhuijs-Moeke Frank J M F Dor Henrik Birn Bente Jespersen |
| author_facet | Marie B Nielsen Nicoline V Krogstrup Mihai Oltean Gertrude J Nieuwenhuijs-Moeke Frank J M F Dor Henrik Birn Bente Jespersen |
| author_sort | Marie B Nielsen |
| collection | DOAJ |
| description | <h4>Background</h4>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).<h4>Methods</h4>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.<h4>Results</h4>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<0.0001 for both mGFR and eGFR estimates). In contrast, DGF i.e. "need of dialysis the first week" did not correlate significantly with one year GFR.<h4>Conclusion</h4>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.<h4>Trial registration</h4>www.ClinicalTrials.gov Identifier: NCT01395719. |
| format | Article |
| id | doaj-art-145a122d22f84f5eb53879625bc5cf24 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-145a122d22f84f5eb53879625bc5cf242025-08-20T02:17:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022688210.1371/journal.pone.0226882Remote 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 NielsenNicoline V KrogstrupMihai OlteanGertrude J Nieuwenhuijs-MoekeFrank J M F DorHenrik BirnBente Jespersen<h4>Background</h4>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).<h4>Methods</h4>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.<h4>Results</h4>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<0.0001 for both mGFR and eGFR estimates). In contrast, DGF i.e. "need of dialysis the first week" did not correlate significantly with one year GFR.<h4>Conclusion</h4>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.<h4>Trial registration</h4>www.ClinicalTrials.gov Identifier: NCT01395719.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226882&type=printable |
| spellingShingle | Marie B Nielsen Nicoline V Krogstrup Mihai Oltean Gertrude J Nieuwenhuijs-Moeke Frank J M F Dor Henrik Birn Bente Jespersen Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study. PLoS ONE |
| title | Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study. |
| title_full | Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study. |
| title_fullStr | Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study. |
| title_full_unstemmed | Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study. |
| title_short | Remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function-A follow-up of the CONTEXT study. |
| title_sort | remote ischaemic conditioning and early changes in plasma creatinine as markers of one year kidney graft function a follow up of the context study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226882&type=printable |
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