Effect of Remote Ischemic Preconditioning on Kidney Injury Among High-Risk Patients Undergoing Cardiac Surgery

240 high risk patients undergoing cardiac surgery were randomized to remote ischemic preconditioning (3 5-min cycles of single upper extremity ischemia after anesthetic induction) or sham.  Preconditioning reduced the incidence of acute kidney injury by one-third and the need for renal replacement therapy by two-thirds.  These results were associated with changes in urinary insulinlike growth factor–binding protein 7 and tissue inhibitor of metalloproteinases 2.  No differences were found between the groups for other major complications.