Inclusion Criteria:  Age 18 years Diagnosis of heart failure with reduced LVEF <50% Pre-procedure intravenous normal saline fluid restriction status Society for Cardiovascular Angiography and Interventions (SCAI) AKI risk score (>1%) Referral for coronary angiogram and/or PCI Suspected stable coronary artery disease or acute coronary syndrome  Exclusion Criteria:  Inability to give informed consent Unstable BP (SBP > 200 or <80 mmHg) at the time of enrolment Upper limb peripheral arterial disease Unavailability of at least one arm for RIPC/Sham-RIPC application Kidney transplant Renal disease requiring dialysis Prior exposure to contrast media within 72hrs preceding coronary angiography Pregnancy Prisoner