Meta-analysis of rosuvastatin efficacy in prevention of contrast-induced acute kidney injury

Zhang, Jing; Guo, Ying; Qi, Jin; Bian, Li; Lin, Ping

doi:10.2147/dddt.s178020

Cited by 18 publications

(13 citation statements)

References 31 publications

(35 reference statements)

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“…A recent systematic evaluation showed that the risk of CA-AKI in high-risk patients, such as those with CKD or DM, can be reduced by short-term use of rosuvastatin before CM administration (OR: 0.53, 95% CI: 0.40 to 0.71, P < 0.0001) [91]. However, the efficacy of statins in the prevention and treatment of CA-AKI remains controversial [92].…”

Section: Treatmentmentioning

confidence: 99%

Contrast-associated acute kidney injury: An update of risk factors, risk factor scores, and preventive measures

et al. 2021

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Section: Treatmentmentioning

confidence: 99%

Contrast-associated acute kidney injury: An update of risk factors, risk factor scores, and preventive measures

et al. 2021

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“…Although the risk of developing CIN is low in patients with good renal status, it is remarkably higher in those with conditions such as diabetes mellitus or chronic kidney disorder [4,28]. Many clinical trials and meta-analysis have con rmed that the incidence of CIN is increasingly common among patients with diabetes mellitus [29]. Given the adverse outcome of this issue, every effort should be done to decrease the incidence of CIN among those high-risk patients.…”

Section: Resultsmentioning

confidence: 99%

High Dose Atorvastatin Raises Threshold of Contrast Induced Nephropathy in Diabetic Patients Undergoing Elective Coronary Intervention.

Abdel-Galeel

Elmaghraby

Ghaleb

et al. 2020

Preprint

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Background Contrast induced nephropathy (CIN) is a significant complication of angiographic procedures resulting from injection of iodinated contrast media (CM). Patients with diabetes mellitus (DM) are at the highest risk of CIN. Statins have recently been proposed for protection against CIN due to their antioxidant and anti-inflammatory propertiesAim of work To investigate the potential benefit of acute pretreatment with high dose atorvastatin (80 mg) in reduction of the incidence of CIN in diabetic patients indicated for elective coronary intervention.Patients and Methods 200 diabetic patients with indication for coronary intervention were enrolled in the study. 100 patients will be randomly assigned to receive atorvastatin (80 mg) just before coronary intervention (statin group) and 100 patients received placebo (control group). CIN was defined as a rise of serum creatinine of more than 25% or ≥0.5 mg/dl (44 μmol/l) from baseline within 48 hours of the angiography. After the procedure, TIMI flow of the culprit vessel was reported, as well as the volume of used contrast media and time of X-ray exposure.Results Our study reported a CIN incidence of 12, 18 and 6% among the whole study, placebo and statin groups respectively, p value 0.001. Among placebo group, CIN is likely to develop after 13.5 minutes X ray exposure time with specificity 73.2% and sensitivity 77.8%, AUC 0.879 (CI: 0.798-0.960), P value 0.001. While in statin group, CIN is likely to develop after 14.5 minutes X ray exposure time with specificity 74.5% and sensitivity 83.3%, AUC 0.818 (CI: 0.727-0.910), P value 0.009. In placebo group, CIN is likely to develop after injection of 145 ml with specificity 75.6% and sensitivity 77.8%, AUC 0.855 (CI: 0.757-0.952), P value 0.001. While in statin group, CIN is likely to develop after injection of 165 ml with specificity 84% and sensitivity 83.3%, AUC 0.878 (CI: 0.811-0.944), P value 0.002Conclusions Acute pre-treatment with high dose atorvastatin can effectively protect against CIN and was associated with a marked decrease in the prevalence of CIN in diabetic patients undergoing coronary interventions. Moreover, pre-treatment with high-dose atorvastatin raises the threshold of X-ray exposure time and amount of contrast media beyond which CIN is likely to develop.

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“…Still, being a patient with diabetes will have a constant risk for ACS and its complications and fatality if compared with others, which their risks decreased over time with introduction of revascularization procedures [ 32 ]. Loading dose of statins prerevascularization was found to be associated with lower risk of CI-AKI and complications [ 33 , 34 ]. In our cohort, the use of statins was also associated with lower rate for events and revascularization.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of Contrast-Induced Acute Kidney Injury: A Study from a Developing Country

Oweis

Alshelleh

Saadeh

et al. 2020

International Journal of Vascular Medicine

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Introduction. Contrast-induced acute kidney injury (CI-AKI) is a worldwide known complication related to the use of contrast media with either imaging or angiography; it carries its own complications and effect on both morbidity and mortality; early identification of patients at risk and addressing modifiable risk factors may help reducing risk for this disease and its complications. Methods. This was a prospective observational study, where all patients admitted for cardiac catheterization between June 2015 and January 2016 were evaluated for CI-AKI. There were two study groups: contrast-induced acute kidney injury (CI-AKI) group, and noncontrast-induced acute kidney injury (non-CI-AKI) group. Results. Patients ( n = 202 ) were included and followed up for 4 years. Death and development of chronic kidney disease (CKD) need for another revascularization were the end points. The incidence of CI-AKI was 14.8%.In univariate analysis, age ( P = 0.016 ) and serum albumin at admission ( P = 0.001 ) were statistically significant predictors of overall death. Age ( P = 0.002 ), HTN ( P = 0.002 ), DM ( P = 0.02 ), and the use of diuretics ( P = 0.001 ) had a statistically significant impact on eGFR. The rate of recatheterization was not statistically significant between the two groups (61 (35.5%) for the non-CI-AKI vs. 12 (40%) for the other group; P = 0.63 ). Some inflammatory markers (NGAL P = 0.06 , IL-19 P = 0.08 ) and serum albumin at admission P = 0.07 had a trend toward a statistically significant impact on recatheterization. Death ( P = 0.66 ) and need for recatheterization ( P = 0.63 ) were not statistically different between the 2 groups, while the rate of eGFR decline in for the CI-AKI was significant ( P = 0.004 ). Conclusion. CI-AKI is a common complication post percutaneous catheterization (PCI), which may increase the risk for CKD, but not death or the need for recatheterization. Preventive measures must be taken early to decrease the morbidity.

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Meta-analysis of rosuvastatin efficacy in prevention of contrast-induced acute kidney injury

Cited by 18 publications

References 31 publications

Contrast-associated acute kidney injury: An update of risk factors, risk factor scores, and preventive measures

Contrast-associated acute kidney injury: An update of risk factors, risk factor scores, and preventive measures

High Dose Atorvastatin Raises Threshold of Contrast Induced Nephropathy in Diabetic Patients Undergoing Elective Coronary Intervention.

Long-Term Follow-Up of Contrast-Induced Acute Kidney Injury: A Study from a Developing Country

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