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In Reply We agree with Drs Redington and Caldarone that many animal and human studies have shown that a single or few (≤5) short episodes of remote ischemic preconditioning (typically 5 minutes of limb ischemia followed by 5 minutes of reperfusion) are protective for many organs (including the heart, brain, and kidney) with few reported adverse effects.
However, few studies have examined the long-term effects of repeated episodes of remote ischemic preconditioning, and this is what we referred to in our Editorial that the effects of multiple episodes of remote ischemic preconditioning, which patients may be exposed to if remote ischemic preconditioning is widely used, are unclear.
Pan JS, Sheikh-Hamad D. Remote Ischemic Preconditioning and Postoperative Renal Dysfunction—Reply. JAMA. 2015;314(14):1520. doi:10.1001/jama.2015.10550