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The following is a summary of “Exploratory testing of functional blood oxygenation level dependent-MRI to image the renoprotective effect of Remote Ischaemic PreConditioning during partial nephrectomy,” published in the December 2024 issue of Urology by Heuzeroth et al.
Urinary biomarker studies show Remote Ischemic PreConditioning (RIPC) offers renal protection in cardiothoracic and kidney-sparing surgery. RIPC induces ischemia and reperfusion in limbs before targeting organ ischemia.
Researchers conducted a retrospective study to investigate whether Blood Oxygenation Level Dependent-MRI (BOLD-MRI) can quantify the renoprotective effect of RIPC on ischemia/reperfusion injury (IRI) after partial nephrectomy (PN).
They enrolled 15 patients in a 1:1 randomized controlled trial, assigning RIPC to the intervention arm. Urinary neutrophil gelatinase-associated lipocalin (NGAL) was measured preoperatively and for 5 days postoperatively, while functional BOLD-MRI was performed preoperatively and 48 hours after PN in 11 patients to assess acute tubular damage via ∆R2* .
The results showed the cumulative urinary NGAL concentration was significantly lower in the RIPC group (P = 0.02), with the highest difference (65% lower) seen 6 hours post-surgery. IRI, measured by ∆R2* in BOLD-MRI, was 2.1 times less pronounced in the RIPC group (∆R2* preop/postop RIPC: 14.73/12.57 vs. noRIPC: 16.33/11.82, P = 0.36).
Investigators demonstrated the potential of BOLD-MRI in measuring IRI and visualizing RIPC’s renoprotective effects. Larger studies were needed to validate these initial findings.
Source: nature.com/articles/s41598-024-83643-6
