Limited Clinical Utility of Remote Ischemic Conditioning in Renal Transplantation: A Meta-Analysis of Randomized Controlled Trials.

Autor:	Zhou CC; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Ge YZ; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Yao WT; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Wu R; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Xin H; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Lu TZ; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Li MH; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Song KW; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Wang M; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Zhu YP; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Zhu M; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China., Geng LG; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China., Gao XF; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China., Zhou LH; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Zhang SL; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Zhu JG; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China., Jia RP; Center for Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.; Department of Urology, Nanjing First Hospital, Nanjing Medical University,Nanjing, Jiangsu, China.
Jazyk:	angličtina
Zdroj:	PloS one [PLoS One] 2017 Jan 27; Vol. 12 (1), pp. e0170729. Date of Electronic Publication: 2017 Jan 27 (Print Publication: 2017).
DOI:	10.1371/journal.pone.0170729
Abstrakt:	Objective: We conducted this meta-analysis of randomized controlled trials (RCTs) to investigate whether remote ischemic conditioning (RIC) could improve graft functions in kidney transplantation. Methods: PubMed, Web of Science, and Cochrane Library were comprehensively searched to identify all eligible studies by October 5, 2016. The treatment effects were examined with risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI). The statistical significance and heterogeneity were assessed with both Z-test and Q-test. Results: A total of six RCTs including 651 recipients, were eventually identified. Compared to the controls, RIC could reduce the incidence of delayed graft function (DGF) after kidney transplantation (random-effects model: RR = 0.89; fixed-effect model: RR = 0.84). However, the decrease did not reveal statistical significance. The subgroup analysis by RIC type demonstrated no significant difference among the three interventions in protecting renal allografts against DGF. Furthermore, no significant difference could be observed in the incidence of acute rejection, graft loss, 50% fall in serum creatinine, as well as the estimated glomerular filtration rate and hospital stay between the RIC and Control groups. Conclusions: This meta-analysis suggested that RIC might exert renoprotective functions in human kidney transplantation, and further well-designed RCTs with large sample size are warranted to assess its clinical efficacy. Competing Interests: The authors have declared that no competing interests exist.
Databáze:	MEDLINE
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