Association of prognostic nutritional index with risk of contrast induced nephropathy: A meta-analysis

Abstract

BackgroundAlthough prognostic nutritional index (PNI) has been frequently applied in patients with malignancy or those during postoperative recovery, whether it is also an optimal indicator of the risk of contrast-induced nephropathy (CIN) in patients receiving coronary angiography remains uncertain. This meta-analysis aimed at investigating the clinical association of PNI with the risk of CIN in patients receiving coronary angiography or percutaneous coronary intervention.MethodsEmbase, Medline, Cochrane Library, and Google scholar were searched for studies until January 2023. The relationship between CIN risk and PNI (i.e., low vs. high) (primary outcome) as well as other variables (secondary outcomes) were analyzed using a random-effects model.ResultsOverall, 10 observational studies with 17,590 patients (pooled incidence of CIN: 18%) were eligible for analysis. There was a higher risk of CIN in patients with a low PNI compared to those with a high PNI [odd ratio (OR) = 3.362, 95% confidence interval (CI): 2.054 to 5.505, p < 0.0001, I2 = 89.6%, seven studies, 12,972 patients, certainty of evidence: very low]. Consistently, a lower PNI was noted in patients with CIN compared to those without (Mean difference = −5.1, 95% CI: −6.87 to −3.33, p < 0.00001, I2 = 96%, eight studies, 15,516 patients, certainty of evidence: very low). Other risks of CIN included diabetes and hypertension, while male gender and the use of statins were associated with a lower risk of CIN. Patients with CIN were older, had a higher creatinine level, and received a higher contrast volume compared to those without. On the other hand, pre-procedural albumin, estimated glomerular filtration rate, ejection fraction, hemoglobin, lymphocyte ratio were found to be lower in patients with CIN than in those without.ConclusionThis meta-analysis highlighted an inverse association of PNI with the risk of CIN, which required further studies for verification.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389185].

Association of Malnutrition with Risk of Acute Kidney Injury: A Systematic Review and Meta-Analysis

“…To our knowledge, this is the first study to examine the correlation between malnutrition and the risk of acute kidney injury (AKI) from a global perspective. Although previous studies have deepened our understanding of the relationship between malnutrition and contrast-induced nephropathy [ 54 ], it is crucial to note that contrast-induced nephropathy and AKI are two different pathologies with distinct etiologies, pathophysiological mechanisms, and clinical presentations. In our research, we focus on the association between malnutrition and AKI.…”

Diagnostic efficacy of the triglyceride–glucose index in the prediction of contrast-induced nephropathy following percutaneous coronary intervention

“…Compared with the TyG index, a recent meta-analysis of four studies involving 1346 patients found that gamma-glutamyl transferase (GGT) levels could potentially predict CIN in patients undergoing cardiac catheterization, showing a significantly higher GGT levels in patients with CIN (odds ratio: 3.21; I 2 :91.93%) (27). In our previous meta-analysis, patients with a low prognostic nutritional index (PNI) demonstrated a higher risk of CIN than those with a high PNI, with an odds ratio of 3.362 (I 2 = 89.6%) (28). Although both GGT levels and PNI appear to have a stronger relationship with CIN than the TyG index, the relatively low heterogeneity in the current meta-analysis highlighted that the TyG index may be a reliable predictor of CIN.…”