Relationship Between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients With Non-ST Segment Elevation Myocardial Infarction Undergoing Coronary Angiography

Hatem, Engin; Aslan, Onur; Demirci, Emre; Yıldırım, Kasım Sinan

doi:10.1177/00033197221113158

Cited by 3 publications

(9 citation statements)

References 43 publications

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“…Subgroup analysis showed that the OR of CIN in patients without ACS was 2.45 (95% CI: 1.729 to 3.471), while the OR was 5.103 (95% CI:1.553 to 16.771) in those with ACS ( Figure 4 ). To support this finding, our further analysis of the PNI in patients with or without CIN also demonstrated a lower PNI in patients with CIN compared to those without (MD = -5.1, 95% CI: −6.87 to −3.33, p < 0.00001, I 2 = 96%, eight studies, 15,516 patients, sensitivity analysis: consistent; certainty of evidence: very low) ( Figure 5 ) ( 7 , 9 , 11 , 16 , 17 , 19 – 21 ).…”

Section: Resultsmentioning

confidence: 90%

“…The male proportion varied among the studies with a range of 54.4 to 84.1%. Six studies enrolled fewer than 1,000 patients (range: 251 to 925) ( 7 , 11 , 15 , 17 , 19 , 20 ), while four recruited more than 1,000 patients (range: 1,823 to 4,391) ( 9 , 16 , 18 , 21 ). All studies used circulating creatinine concentrations to determine the incidence of CIN in their participants.…”

Section: Resultsmentioning

confidence: 99%

“…The cut-off values for this binary variable are shown in Table 1 . The ten included studies were conducted in three countries: Korea ( n = 1) ( 16 ), China ( n = 2) ( 9 , 21 ), and Turkey ( n = 7) ( 7 , 11 , 15 , 17 – 20 ).…”

Section: Resultsmentioning

confidence: 99%

“…The quality of studies based on NOS is demonstrated in Table 1 . Six studies were considered to have a low risk of bias (range of total stars: 7–9) ( 7 , 9 , 17 – 19 , 21 ), while four were judged to be of low quality (range of total stars: 4–6) ( 11 , 15 , 16 , 20 ).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were further excluded for the following reasons: (1) patients receiving cardiac surgery (n = 1); (2) articles presented as conference abstracts (n = 4); and (3) information related to PNI not provided (n = 3). Finally, a total of 10 studies with 17,590 patients were included for the current meta-analysis (Figure 1) (7,9,11,(15)(16)(17)(18)(19)(20)(21).…”

Section: Selection Characteristics and Quality Of Studiesmentioning

confidence: 99%

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

Chang

Sun

et al. 2023

Front. Nutr.

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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].

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Selection Characteristics and Quality Of Studiesmentioning

confidence: 99%

See 3 more Smart Citations

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

Chang

Sun

et al. 2023

Front. Nutr.

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Letter: Prognostic Nutritional Index as a Novel Biomarker of Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome

Li,

Wang

2023

Angiology

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Prognostic nutritional index as a predictive marker for acute kidney injury in adult critical illness population: a systematic review and diagnostic test accuracy meta-analysis

Chen,

Lee,

Lai

et al. 2024

j intensive care

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Background The prognostic nutritional index (PNI), integrating nutrition and inflammation markers, has been increasingly recognized as a prognostic predictor in diverse patient cohorts. Recently, its effectiveness as a predictive marker for acute kidney injury (AKI) in various clinical settings has gained attention. This study aims to assess the predictive accuracy of the PNI for AKI in critically ill populations through systematic review and meta-analysis. Methods A systematic review was conducted using the databases MEDLINE, EMBASE, PubMed, and China National Knowledge Infrastructure up to August 2023. The included trials reported the PNI assessment in adult population with critical illness and its predictive capacity for AKI. Data on study characteristics, subgroup covariates, and diagnostic performance of PNI, including sensitivity, specificity, and event rates, were extracted. A diagnostic test accuracy meta-analysis was performed. Subgroup analyses and meta-regression were utilized to investigate the sources of heterogeneity. The GRADE framework evaluated the confidence in the meta-analysis’s evidence. Results The analysis encompassed 16 studies with 17 separate cohorts, totaling 21,239 patients. The pooled sensitivity and specificity of PNI for AKI prediction were 0.67 (95% CI 0.58–0.74) and 0.74 (95% CI 0.67–0.80), respectively. The pooled positive likelihood ratio was 2.49 (95% CI 1.99–3.11; low certainty), and the negative likelihood ratio was 0.46 (95% CI 0.37–0.56; low certainty). The pooled diagnostic odds ratio was 5.54 (95% CI 3.80–8.07), with an area under curve of summary receiver operating characteristics of 0.76. Subgroup analysis showed that PNI’s sensitivity was higher in medical populations than in surgical populations (0.72 vs. 0.55; p < 0.05) and in studies excluding patients with chronic kidney disease (CKD) than in those including them (0.75 vs. 0.56; p < 0.01). Overall, diagnostic performance was superior in the non-chronic kidney disease group. Conclusion Our study demonstrated that PNI has practical accuracy for predicting the development of AKI in critically ill populations, with superior diagnostic performance observed in medical and non-CKD populations. However, the diagnostic efficacy of the PNI has significant heterogeneity with different cutoff value, indicating the need for further research.

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Relationship Between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients With Non-ST Segment Elevation Myocardial Infarction Undergoing Coronary Angiography

Cited by 3 publications

References 43 publications

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

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

Letter: Prognostic Nutritional Index as a Novel Biomarker of Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome

Prognostic nutritional index as a predictive marker for acute kidney injury in adult critical illness population: a systematic review and diagnostic test accuracy meta-analysis

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