Effect Of Remote Ischaemic Preconditioning On Renal Function In Patients Undergoing Allograft Donor Kidney Transplantation

Objective:To investigate effect of remote ischaemic preconditioning on renal function in patients undergoing allograft donor kidney transplantation.Methods:Choose twenty patients (17male and3female) whose age is17to60years old in General Hospital of Shenyang Command of PLA. This patients undergoing allograft donor kidney transplantation were randomly assigned to either a remote ischaemic preconditioning (RIPC) group (n=11) or to a control group (n=9) after the double segment technique of combined spinal epidural anesthesia. Remote ischemic preconditioning was induced by four5-min cycles of left lower extremity ischemia and5-min reperfusion using a tourniquet inflated to a pressure15mmHg greater than the systolic arterial pressure measured via the arterial line in the RIPC group. Control patients underwent sham placement of the tourniquet wrapped around the left lower extremity without inflation.24h urine volume, blood urea nitrogen (BUN) and serum creatinine (Scr) concentration was measured at24,48and72h after surgery. Detection of urinary microalbumin (mAlb), β2-microglobulin (β2-MG) and kidney injury molecule-1(Kim-1) level was made at12,24,48and72h after operation.:Results:The RIPC group had significantly more urine volume than control group in the3days after operation (p<0.05). All patients were similar in blood urea nitrogen and serum creatinine at24and48h after surgery (p>0.05). But compared with control group, blood urea nitrogen and serum creatinine decreased significantly at72h post-operation in the RIPC group (p<0.05). There was no significant difference in β2-microglobulin and microalbumin at12,24and48h after surgery between the two groups (p>0.05).But compared with control group, β2-microglobulin and microalbumin72h post-operation in the RIPC group (p<0.05).Compared with control group, the kidney injury molecule-1level of RIPC group is no different at12and24h after operation (p>0.05), but the kidney injury molecule-1level of RIPC group decreased significantly at48and72h post-operation (p<0.05).Conclusion:Remote ischaemic preconditioning can improve renal function through delayed protection in patients undergoing allograft donor kidney transplantation.