Correspondence  |   December 2017
Can Remote Ischemic Preconditioning Really Improve Long-term Kidney Outcomes after Cardiac Surgery?
Author Notes
  • Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China (F.-S.X.). xuefushan@aliyun.com
  • (Accepted for publication September 20, 2017.)
    (Accepted for publication September 20, 2017.)×
Article Information
Correspondence
Correspondence   |   December 2017
Can Remote Ischemic Preconditioning Really Improve Long-term Kidney Outcomes after Cardiac Surgery?
Anesthesiology 12 2017, Vol.127, 1040. doi:10.1097/ALN.0000000000001932
Anesthesiology 12 2017, Vol.127, 1040. doi:10.1097/ALN.0000000000001932
In a follow-up study for their previous RenalRIP trial, Zarbock et al.1  show that remote ischemic preconditioning significantly decreases the 3-month incidence of a composite endpoint for major adverse kidney events including mortality, the need for renal replacement therapy, and persistent renal dysfunction in high-risk patients undergoing cardiac surgery. It must be pointed out, however, that the risk of long-term adverse kidney outcomes following cardiac surgery is mainly associated with incidence, severity, and duration of acute kidney injury (AKI) in the early postoperative period. Specifically, nonrecovery from AKI is more common in patients with more severe AKI and is significantly attributable to long-term adverse kidney outcomes.2  The potentially causal relationship between postoperative AKI and long-term adverse kidney outcomes may partly explain the long-term mortality associations observed in patients with AKI after cardiac surgery.
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