Effect of Propofol versus sevoflurane on the renoprotective effects of remote ischemic preconditioning (RIPC) in high-risk patients undergoing cardiac surgery

Purpose Remote ischemic preconditioning (RIPC) has been shown to effectively reduce acute kidney injury (AKI) in high-risk patients after cardiac surgery. The anesthetic Propofol seems to have a preconditioning blocking effect. The RIPC effects are associated with early and transient increases of the two cell cycle arrest markers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7). The purpose of this study is to investigate the effect of different anesthetic regimens on the RIPC required changes in [TIMP-2]*[IGFBP7] levels.

This study is designed as a single center, randomized controlled, clinical trial among high-risk patients undergoing cardiac surgery with cardiopulmonary bypass. Patients are randomized to receive either Propofol +sham-RIPC, Propofol+RIPC, sevoflurane +sham-RIPC or Sevoflurane +RIPC. The primary endpoint is the change in urinary [TIMP2]*[IGFBP7] levels. Secondary outcomes include the incidence of AKI within 72h after cardiac surgery according to the KDIGO (Kidney Disease Improving Global Outcomes) definition.