Trial reportBritish journal of anaesthesia2025
Impact of propofol or sevoflurane on the renoprotective effect of remote ischaemic preconditioning in cardiac surgery: the HypnoRenalRIP randomised clinical trial.
Trial report in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- The role of hypoxia-inducible factors in myocardial ischaemia-reperfusion injury and cardioprotection.Nature reviews. Cardiology · 2026Review
- Update on Perioperative Prevention of Cardiac Surgery-Associated Acute Kidney Injury.Journal of clinical medicine · 2026Review
- Translational Barriers and Optimization Strategies for Remote Ischemic Conditioning to Enhance Stroke Cerebroprotection.Biomolecules · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRemote ischaemic preconditioning (RIPC) might reduce acute kidney injury after cardiac surgery. Protective effects appear to be restricted to patients with early and transient increases in two cell cycle arrest markers, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7), in urine. Studies suggest that propofol can attenuate the preconditioning effect on the myocardium. This study investigated whether propofol diminishes the renoprotective effect associated with the early transient increases in TIMP-2 and IGFBP7.
methodsThis was a single-centre, prospective randomised double-blind 2×2 factorial clinical trial of high-risk patients undergoing cardiac surgery. Patients were randomised to receive either propofol+sham-RIPC, propofol+RIPC, sevoflurane+sham-RIPC, or sevoflurane+RIPC. The primary outcome measure was the change in the product of urinary concentrations of TIMP-2 and IGFBP7 ([TIMP-2]·[IGFBP7]) from before to after the intervention.
resultsWe enrolled 160 participants in the trial (propofol+sham-RIPC: n=20, propofol+RIPC: n=60, sevoflurane+sham-RIPC: n=20, sevoflurane+RIPC: n=60). The median change in [TIMP-2]·[IGFBP7] as an indicator of response to RIPC was greater in participants receiving sevoflurane (0.070; interquartile range, -0.120 to 0.418) compared with those receiving propofol (-0.015; interquartile range, -0.138 to 0.068; P=0.022). Conversely, elevated [TIMP-2]·[IGFBP7] as a sign of renal stress in response to surgery was detected in all groups except for sevoflurane+RIPC (P=0.001). There were no statistically significant differences in patient-centred outcomes between groups.
conclusionsTransient increases in [TIMP-2]·[IGFBP7] induced by RIPC, which were associated with renoprotective effects, were only seen with sevoflurane anaesthesia, but not when propofol was used. The association of biomarker concentrations and choice of anaesthetic agent suggests that propofol can attenuate the renoprotective effects of remote ischaemic preconditioning. CLINICAL
trial registrationDRKS00014989.
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