Anemia is associated with increased risk of contrast‑induced acute kidney injury: A Systematic Review and Meta-analysis

Abstract

Previous studies have identified numerous risk factors of contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary angiography. However, the association between anemia and CI-AKI remains conflicting. Thus, we conducted a meta-analysis to further clarify the relationship between anemia and CI-AKI. PubMed, EMBASE and Web of Science were systematically searched from inception to June 2020 to identify eligible studies. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to estimate the correlation between anemia and CI-AKI. The potential publication bias was estimated using funnel plot and Begg’s test. A total of 13 studies (five case-control studies and eight cohort studies) comprising 27,135 patients were included. The pooled results showed that anemia was a significant risk factor of CI-AKI (OR, 1.82; 95% CI, 1.27–2.61). Moreover, the results of subgroup analyses and sensitivity analyses were basically consistent with the overall pooled result. Funnel plot and Begg’s test indicated that there existed potential publication bias, but the result of trim and filled analysis showed that the pooled results kept stable after adding ‘missing’ studies. This meta-analysis suggested that anemia may be correlated with an increased incidence of CI-AKI in patients undergoing coronary angiography. However, our conclusions should be interpreted with caution due to some limitations. Therefore, further high-quality trials should be conducted to confirm our findings.

Development and Validation of a Risk Nomogram Model for Predicting Contrast-Induced Acute Kidney Injury in Patients with Non-ST-Elevation Acute Coronary Syndrome Undergoing Primary Percutaneous Coronary Intervention

“…Therefore, erythropoietin deficiency in anemia individuals may lead to further deterioration of renal function. 37 However, the present study did not yield similar results, probably since 68% of the patients in the present study were male, and this significant gender imbalance produced a bias. Simultaneously, Pre-procedure renal function was expected in the NSTE-ACS patients enrolled in our study.…”

Contrast-induced acute kidney injury and its contemporary prevention

“…Anemia Systematic review and meta-analysis Wei et al (191) Hypotension Systematic review and meta-analysis Ong et al (192) Volume Depletion and Hemodynamic Instability Systematic review and meta-analysis Tea et al (193) NSAID, diuretics and other nephrotoxic drugs Systematic review and meta-analysis Zhang et al (194) ACE-I/ARB usage Randomized trial parallel-group, single-center CAPTAIN trial (195) Acute heart failure NYHA III-IV Multicenter retrospective study Tian et al (196) Hypoalbuminemia Systematic review and meta-analysis Liwei et al (197) Peri-procedural hyperglycemia Systematic review and meta-analysis Jakrin et al (198) Patient…”

Aminoglycosides use has a risk of acute kidney injury in patients without prior chronic kidney disease

“…Anemia has been more frequently considered a factor associated with the severity of comorbid disease or poor disease prognosis. The impact of anemia has been reported for AKI episodes in anemic patients who use contrast media 20 , patients with preoperative and postoperative anemia 37 , 38 , and patients with critical illnesses 39 . In our study, we found that anemia (HGB < 13 g/dL) was a risk factor for AKD stage 1.…”

“…Baseline HGB and ALB were also divided into high/low HGB (≥ 13 g/dL/ < 13 g/dL) and ALB (≥ 3.5 g/dL/ < 3.5 g/dL) groups. According to these studies 20 , 21 , the definitions of anemia and hypoalbuminemia were HGB < 13 g/dL and ALB < 3.5 g/dL, respectively. The following comorbidities 1 year before the index date were recorded as confounding factors (CKD, hypertension, diabetes mellitus, hyperlipidemia, acute myocardial infarction, ischemic stroke, peripheral artery disease (PAD), chronic obstructive pulmonary disease (COPD), and chronic liver disease (CLD)).…”