Acute kidney injury (AKI) is a common and serious complication of cardiac surgery. Cardiac surgery–associated AKI (CS-AKI) results in adverse outcomes, prolonged hospital stays, increased medical costs, and higher mortality rates. Therefore, preventive interventions for CS-AKI are crucial. Remote ischemic preconditioning (RIPC) is a promising nonpharmacological intervention for preventing CS-AKI. This review discusses the mechanisms underlying the renoprotective effects of RIPC, recent clinical studies suggesting that RIPC reduces the incidence of CS-AKI, factors influencing its effects, and precautions for its clinical application. However, the clinical implementation of RIPC presents challenges and debates owing to inconsistent findings across trials and the lack of standardized intervention protocols. Given the complex pathophysiology of the occurrence and progression of AKI, including CS-AKI, the renoprotective effect of RIPC deserves more attention and further research.
Bai et al. (2026) studied this question.