Efficacy of alprostadil in preventing contrast‐induced nephropathy in patients undergoing percutaneous coronary intervention: A multicenter prospective randomized controlled trial

Liang, Min; Yang, Shicheng; Fu, Naikuan; Lu, Chengzhi; Tian, Fengshi; Xiaochun, Xing; Lin, Wenhua; Liu, Jingjing

doi:10.1002/ccd.27353

Cited by 10 publications

(17 citation statements)

References 26 publications

(39 reference statements)

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“…We analyzed the patients diagnosed as CI-AKI based on Scr changes. All 7 trials reported the postprocedural Scr values at 48 hours (study Wang et al [ 14 ] did not report the mean and standard deviation of postprocedural Scr, so could not be used for the analysis of postprocedural Scr) and 4 trials [ 3 , 4 , 12 , 13 ] also reported the postprocedural Scr values at 72 hours.…”

Section: Resultsmentioning

confidence: 99%

“…Among those 7 RCTs, 2 [ 3 , 12 ] enrolled older patients (older than 70 years and 60 years respectively); 2 [ 4 , 9 ] enrolled patients with impaired renal function (Scr ≥ 1.5 mg/dL; eGFR: 60–89 mL/min/1.73 m 2 respectively) and patients with a higher risk developing CI-AKI (CIN risk score ≥ 11) were included in one study. [ 11 ] Patients whose eGFR ≤ 30 mL/min/1.73 m 2 were excluded in 1 study [ 13 ] and the remaining study included only patients with diabetes. [ 14 ]…”

Section: Resultsmentioning

confidence: 99%

“…2 and 3 separately, which evaluated the relevant study characteristics according to Cochrane Handbook for Systematic Reviews of Interventions. Only 1 trial [ 13 ] reported method of random sequence generation and none described the concealment of allocation. One study [ 8 ] did not describe the definition of CI-AKI in advance.…”

Section: Resultsmentioning

confidence: 99%

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Prostaglandin E1 administration for prevention of contrast-induced acute kidney injury

et al. 2018

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Background:PGE1 has been studied for prevention of CI-AKI in several RCTs and significant heterogeneous results exist.Methods:We searched PubMed, EMBase, and Cochrane Central Register of Controlled Trials up to December 26, 2017 for RCTs comparing PGE1 with placebo or other active medications for the prevention of CI-AKI in patients. Odds ratio and 95% confidence interval (CI) were used for pooling dichotomous data, while mean difference and 95% confidence interval for pooling continuous data.Results:Seven RCTs involving 1760 patients were included in this meta-analysis. All these 7 trials reported the incidence of CI-AKI and compared with placebo or other treatment options, PGE1 was associated with a reduced risk of CI-AKI (OR: 0.38, 95% CI: 0.28–0.53; P < .001) and only a trend for lower post procedure serum creatinine (Scr) levels compared with control groups at 48 hours (MD: −0.03 mg/dL, 95% CI: −0.08 to 0.02 mg/dL; P = .25; 6 trials combined). But the postprocedure Scr levels were significantly reduced in PGE1 groups compared with control groups at 72 hours (MD: −0.07 mg/dL, 95% CI: −0.11 to −0.04 mg/dL; P < .001; 4 trials combined). We also meta-analyzed the postprocedure cystatin C (CysC) at 24 and 48 hours with 2 trials. There were lower postprocedure CysC levels in PGE1 groups than those in control groups (MD: −0.18 mg/L, 95% CI: −0.33 to −0.03 mg/L; P = .02 at 24 hours and MD: −0.14 mg/L, 95% CI: −0.23 to −0.06 mg/L; P = .001 at 48 hours).Conclusions:PGE1 provides effective nephroprotection against CI-AKI and may act as a part of effective prophylactic pharmacological regimens.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Prostaglandin E1 administration for prevention of contrast-induced acute kidney injury

et al. 2018

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“…The qualified articles were then downloaded for detailed assessment. Finally, data for 5495 patients extracted from 36 articles 25 –60 were used in this meta-analysis. A total of 2746 patients were in the experimental group and 2749 patients were in the control group.…”

Section: Resultsmentioning

confidence: 99%

“…All 36 studies were RCTs and mentioned that a randomization method was used, but some of the articles described the blind method. 25 –60 Selective reporting of the results, incomplete data outcome, and other biases in the articles were low. The literature quality score is shown in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials

et al. 2019

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Contrast-induced nephropathy (CIN) is the third leading cause of acquired acute renal injury in hospitalized patients. Alprostadil plays a role in the maintenance and redistribution of intrarenal blood flow and the excretion of electrolytes and water. However, the effectiveness of alprostadil in preventing CIN remains controversial. Thirty-six articles with a total of 5495 patients were included in this study. Both groups (experimental group and control group) received standard hydration therapy. In the experimental group, patients received different doses of alprostadil. Serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), cystatin C, creatinine clearance rate (CCr), and β2-microglobulin (β2-MG) were measured at 24, 48, and 72 hours after contrast media injection. The incidence of CIN in the experimental group was significantly lower than that in the control group (6.56% vs 16.74%). The level of SCr, cystatin C, BUN, and β2-MG in the experimental group was lower than those in the control group; CCr and eGFR in the experimental group were higher than those in the control group. This study demonstrated that alprostadil may reduce the incidence of CIN in patients undergoing coronary angiogram and/or percutaneous coronary intervention.

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Lipid microsphere‐coated PGE1 improves peritoneal transport and reduces inflammation in peritoneal dialysis: A randomized clinical pilot trial

Wang

Tang

Xie

et al. 2021

Seminars in Dialysis

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Social and healthcare improvements have prolonged individuals' lifespan worldwide, while they have resulted in an increased number of patients with end-stage renal disease (ESRD). 1 Peritoneal dialysis (PD) is extensively applied in the treatment of ESRD, with comparable outcomes to hemodialysis, including preservation of residual renal function, 2 being cost-effective, and higher quality of life. 3 In recent years, PD utilization has greatly attracted clinicians' attention in China, and over 250,000 patients have received PD according to the statistics reported in 2012. 4 However, peritoneal transport function gradually diminishes with the extended use of PD, and can eventually lead to ultrafiltration failure. [5][6][7] The dialysate/plasma creatinine ratio (D/Pcr) and the mass transfer area coefficient (MTAC) for urea (MTAC-urea) and creatinine (MTAC-creatinine) are commonly used indicators to assess peritoneal transport of small molecular solutes. 8 A specific correlation was reported between D/Pcr and MTAC-creatinine, and a change in MTAC can influence the effective peritoneal surface area. 9 In addition to the transport of creatinine and other small molecular

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Efficacy of alprostadil in preventing contrast‐induced nephropathy in patients undergoing percutaneous coronary intervention: A multicenter prospective randomized controlled trial

Abstract: Prophylactic administration of alprostadil may prevent against CIN in coronary heart disease patients undergoing elective PCI, particularly in high-risk patients with diabetes mellitus.

Cited by 10 publications

References 26 publications

Prostaglandin E1 administration for prevention of contrast-induced acute kidney injury

Prostaglandin E1 administration for prevention of contrast-induced acute kidney injury

Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials

Lipid microsphere‐coated PGE1 improves peritoneal transport and reduces inflammation in peritoneal dialysis: A randomized clinical pilot trial

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