Nephro Trial Files: Delayed vs. Sham RIPC on CA-AKI, Follow-Up After AKI, and Cefepime vs. Pip-Tazo on AKI Incidence
Remote ischaemic pre-conditioning, kidney injury, and outcomes after coronary angiography and intervention
Jia P et al. European Heart Journal (March 2025)
Bottom Line: This multicentre, randomized trial investigated the effects of delayed remote ischaemic pre-conditioning (RIPC) on contrast-associated acute kidney injury (CA-AKI) in 501 patients at risk undergoing elective coronary angiography (CAG) or percutaneous coronary intervention (PCI). Patients were assigned to receive either delayed RIPC (four cycles of 5 min inflations on one upper arm 24 hours before the procedure) or sham RIPC. The primary outcome was the incidence of AKI, defined by the Kidney Disease Improving Global Outcomes criteria, with results showing 3.2% in the intervention group and 7.6% in the comparator group (odds ratio 0.4, 95% CI 0.17-0.94; P = .03). The study suggests that delayed RIPC may reduce CA-AKI incidence, warranting further investigation in larger trials.
Advancing Community Care and Access to Follow-Up after Acute Kidney Injury Hospitalization
Pannu N et al. JASN (March 2025)
Bottom Line: This randomized controlled trial conducted in Alberta, Canada, evaluated a risk-guided transition of care intervention for adults hospitalized with KDIGO stage 2 or greater AKI. A total of 155 participants were recruited, with a mean age of 60 years. The primary outcome was the proportion of patients receiving ACE-I/ARB, statin treatment, and nephrologist follow-up within 90 days of discharge, which was 28% in the intervention group compared to 3% in usual care (absolute risk difference 25%; 95% CI, 15% to 36%). Safety outcomes indicated increased hyperkalemia in the intervention group. The study concluded that the intervention improved adherence to recommended care processes for CKD in high-risk AKI survivors.
Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection (ACORN)
Qian ET et al. JAMA (October 2023)
Bottom Line: The Antibiotic Choice on Renal Outcomes (ACORN) randomized clinical trial compared cefepime vs piperacillin-tazobactam in hospitalized adults for empirical treatment of infection. The study included 2511 patients and the primary outcome was the highest stage of acute kidney injury or death by day 14. The results showed no significant difference between the two groups, but patients in the cefepime group experienced more neurological dysfunction.
Nephro Trial Files Issue #NPH-2025-08
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