Open AccessLimited Clinical Utility of Remote Ischemic Conditioning in Renal Transplantation: A Meta-Analysis of Randomized Controlled Trials
Author(s) -
Changcheng Zhou,
YuZheng Ge,
Wen-Tao Yao,
Rongqian Wu,
Xin Hui,
Tian-Ze Lu,
Minghao Li,
Kai-Wei Song,
Min Wang,
Yunpeng Zhu,
Meng Zhu,
Li-Guo Geng,
Xiaofei Gao,
Ling Zhou,
Shengli Zhang,
Jun Zhu,
Ru Jia
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0170729
Subject(s) - medicine , meta analysis , transplantation , randomized controlled trial , kidney transplantation , renal function , cochrane library , subgroup analysis , statistical significance , relative risk , creatinine , confidence interval , incidence (geometry) , sample size determination , physics , statistics , mathematics , optics
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.