Prospective randomized study on the impact of remote ischemic preconditioning on contrast induced nephropathy in endovascular aortic repair patients

120 patients undergoing elective endovascular aortic repair (EVAR), mean age 73 years, 98.3% male. Key comorbidities: diabetes (29.16%), preoperative chronic renal failure with eGFR < 60 ml/min (38.33%).

Remote ischemic preconditioning (RIPC) performed in the 12 hours prior to surgery (4 cycles of 5 minutes inflation of a sphygmomanometer on the non-dominant upper extremity to systolic blood pressure + 20 mmHg, followed by 5 minutes of deflation), in addition to standard fluid therapy (1 ml/kg/h starting 12 hours before contrast).

Standard fluid therapy alone (1 ml/kg/h starting 12 hours before contrast administration).

Incidence of contrast-induced nephropathy (CIN) in the first 48 hours post-contrast administration (defined as acute worsening of renal function >0.5 mg/dl or >25%).surrogate