Preclinical Evidence for the Efficacy of Ischemic Postconditioning against Renal Ischemia-Reperfusion Injury, a Systematic Review and Meta-Analysis
| Autor: | Theo P. Menting, Merel Ritskes-Hoitinga, Michiel C. Warlé, Simone J. Jonker, Kimberley E. Wever |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] lcsh:Medicine 030204 cardiovascular system & hematology Kidney urologic and male genital diseases Biochemistry Vascular Medicine 0302 clinical medicine Mathematical and Statistical Techniques Ischemia Medicine and Health Sciences Renal Transplantation lcsh:Science Ischemic Preconditioning Kidney transplantation Multidisciplinary medicine.anatomical_structure Reperfusion Injury Creatinine Physical Sciences Cardiology Female Kidney Diseases Anatomy Renal Ischemia Statistics (Mathematics) Research Article medicine.medical_specialty Histology Surgical and Invasive Medical Procedures Research and Analysis Methods Urinary System Procedures 03 medical and health sciences Internal medicine medicine Animals Humans cardiovascular diseases Statistical Methods Intensive care medicine Transplantation Renal ischemia urogenital system business.industry lcsh:R Biology and Life Sciences Organ Transplantation Renal System medicine.disease Kidney Transplantation Rats Clinical trial Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Animal Studies Ischemic preconditioning lcsh:Q business Reperfusion injury 030217 neurology & neurosurgery Biomarkers Mathematics Meta-Analysis |
| Zdroj: | PLoS ONE PLoS One, 11, 3 PLoS One, 11 PLoS ONE, Vol 11, Iss 3, p e0150863 (2016) |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0150863 |
| Popis: | Contains fulltext : 171225.PDF (Publisher’s version ) (Open Access) BACKGROUND: Renal ischemia-reperfusion injury (IRI) is a major cause of kidney damage after e.g. renal surgery and transplantation. Ischemic postconditioning (IPoC) is a promising treatment strategy for renal IRI, but early clinical trials have not yet replicated the promising results found in animal studies. METHOD: We present a systematic review, quality assessment and meta-analysis of the preclinical evidence for renal IPoC, and identify factors which modify its efficacy. RESULTS: We identified 39 publications studying >250 control animals undergoing renal IRI only and >290 animals undergoing renal IRI and IPoC. Healthy, male rats undergoing warm ischemia were used in the vast majority of studies. Four studies applied remote IPoC, all others used local IPoC. Meta-analysis showed that both local and remote IPoC ameliorated renal damage after IRI for the outcome measures serum creatinine, blood urea nitrogen and renal histology. Subgroup analysis indicated that IPoC efficacy increased with the duration of index ischemia. Measures to reduce bias were insufficiently reported. CONCLUSION: High efficacy of IPoC is observed in animal models, but factors pertaining to the internal and external validity of these studies may hamper the translation of IPoC to the clinical setting. The external validity of future animal studies should be increased by including females, comorbid animals, and transplantation models, in order to better inform clinical trial design. The severity of renal damage should be taken into account in the design and analysis of future clinical trials. |
| Databáze: | OpenAIRE |
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