Efficacy of different pharmacological interventions in the prevention of contrast-induced acute kidney injury after percutaneous coronary intervention: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

LIANG Shichu ¹ , ZHANG Jing ¹ , LI Jing ² , MA Min ¹ , CHEN Zhonglan ¹ , HE Yong ¹ ,  HUANG He ¹

1. Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Research Center of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

HUANG He, Email: huanghe@wchscu.cn

Keywords：

Contrast-induced acute kidney injury; Coronary heart disease; Percutaneous coronary intervention; Overviews of systematic reviews

DOI：

10.7507/1672-2531.202112124

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze systematic reviews (SRs) and meta-analyses on the efficacy of pharmacological interventions in the prevention of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). Methods We searched the PubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data, and VIP databases to identify SRs and meta-analyses on the pharmacological interventions aimed at preventing CI-AKI after PCI from inception of the databases to February 2022. Two researchers independently screened the literature and extracted data. The PRISMA statement, AMSTAR 2 tool, and GRADE system were adopted to evaluate the reporting quality, methodological quality, and evidence quality of the findings of the included SRs and meta-analyses. Results A total of 14 SRs and meta-analyses were identified. Among the drugs used were statins, N-acetylcysteine, sodium bicarbonate, Dan-hong injection, vitamins, salvianolate, adenosine antagonists, nicorandil, allopurinol, alprostadil, furosemide, trimetazidine, probucol, and brain natriuretic peptide. Most of the studies had relatively comprehensive coverage of the items, with the PRISMA scores ranging from 18 to 24.5. The main issues of reporting quality were protocol and registration, search, and funding. The methodological quality of the SRs and meta-analyses was generally low. Items 2 and 7 were the key items with poor scores, and the non-critical items with poor scores were items 3, 10, and 16. All drugs, except furosemide, decreased the incidence of CI-AKI. The quality of evidence ranged from medium to very low according to GRADE. Conclusion Most of the single drugs or drugs combined with hydration show the potential to prevent CI-AKI, however, the overall methodological quality of the included studies is relatively low, and the strength of evidence is generally low.

Citation： LIANG Shichu, ZHANG Jing, LI Jing, MA Min, CHEN Zhonglan, HE Yong, HUANG He. Efficacy of different pharmacological interventions in the prevention of contrast-induced acute kidney injury after percutaneous coronary intervention: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2022, 22(5): 575-584. doi: 10.7507/1672-2531.202112124 Copy

1.	Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation, 2021, 143(8): e254-e743.
2.	中國心血管健康與疾病報告編寫組. 中國心血管健康與疾病報告2020概要. 中國循環雜志, 2021, 36(6): 521-545.
3.	中華醫學會心血管病學分會介入心臟病學組, 中華醫學會心血管病學分會大血管病學組, 中華心血管病雜志編輯委員會. 經動脈心血管介入診治中含碘對比劑相關不良反應防治的中國專家共識(2021). 中華心血管病雜志, 2021, 49(10): 972-985.
4.	Lun Z, Liu L, Chen G, et al. The global incidence and mortality of contrast-associated acute kidney injury following coronary angiography: a meta-analysis of 1. 2 million patients. J Nephrol, 2021, 34(5): 1479-1489.
5.	Bei W, Li H, Lin K, et al. Post-Hoc Study: intravenous hydration treatment in Chinese patients with high risk of contrast-induced nephropathy following percutaneous coronary intervention. Sci Rep, 2017, 7: 45023.
6.	Su X, Xie X, Liu L, et al. Comparative effectiveness of 12 treatment strategies for preventing contrast-induced acute kidney injury: a systematic review and Bayesian network meta-analysis. Am J Kidney Dis, 2017, 69(1): 69-77.
7.	Giacoppo D, Gargiulo G, Buccheri S, et al. Preventive strategies for contrast-induced acute kidney injury in patients undergoing percutaneous coronary procedures: evidence from a hierarchical Bayesian network meta-analysis of 124 trials and 28 240 patients. Circ Cardiovasc Interv, 2017, 10(5): e004383.
8.	中華醫學會放射學分會質量控制與安全管理專業委員會. 腎病患者靜脈注射碘對比劑應用專家共識. 中華放射學雜志, 2021, 55(6): 580-590.
9.	高洪陽, 趙陽, 高蕊, 等. Cochrane Overview的研究現狀及制作方法調查. 中國循證醫學雜志, 2014, 14(12): 1514-1519.
10.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339: b2535.
11.	王靖, 劉琴, 翁淳光, 等. 國內公共衛生研究領域系統評價/Meta分析的質量評價. 中國循證醫學雜志, 2010, 10(12): 1367-1374.
12.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
13.	張方圓, 沈傲梅, 曾憲濤, 等. 系統評價方法學質量評價工具AMSTAR 2解讀. 中國循證心血管醫學雜志, 2018, 10(1): 14-18.
14.	陳耀龍, 姚亮, Susan Norris, 等. GRADE在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
15.	李婷, 弓旭東, 張雪峰, 等. 他汀預防心臟介入手術患者造影劑腎病的Meta分析. 中國循證醫學雜志, 2015, 15(11): 1277-1283.
16.	Wang N, Qian P, Kumar S, et al. The effect of N-acetylcysteine on the incidence of contrast-induced kidney injury: a systematic review and trial sequential analysis. Int J Cardiol, 2016, 209: 319-327.
17.	張斌, 梁龍, 陳文波, 等. 碳酸氫鈉預防對比劑腎病療效的Meta分析. 臨床放射學雜志, 2015, 34(7): 1152-1158.
18.	齊春霞, 吳偉, 褚慶民, 等. 丹紅注射液聯合水化預防造影劑腎病療效的系統評價與Meta分析. 中西醫結合心腦血管病雜志, 2017, 15(5): 570-573.
19.	唐庚, 馬根山. 維生素預防冠狀動脈造影術后對比劑腎病的Meta分析. 中國循環雜志, 2018, 33(2): 181-186.
20.	習元堂, 袁麗宜, 徐思婷, 等. 丹參多酚酸鹽靜脈滴注聯合水化預防造影劑腎病療效的Meta分析. 中國中藥雜志, 2019, 44(12): 2616-2626.
21.	Zang H, Zhang Q, Li X. Adenosine antagonists for prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials with trial sequential analysis. Exp Ther Med, 2019, 18(1): 85-98.
22.	Pranata R, Vania R, Alkatiri AA, et al. Nicorandil reduces the incidence of contrast-induced nephropathy in patients undergoing coronary angiography/intervention-systematic review and meta-analysis of randomized controlled trials including GRADE qualification. Cardiovasc Revasc Med, 2020, 21(9): 1121-1127.
23.	馬光, 王國良, 侯德和, 等. 別嘌呤醇聯合水化對冠狀動脈介入術后造影劑腎病預防作用的Meta分析. 中國循證心血管醫學雜志, 2020, 12(7): 788-793.
24.	Xu H, Wang H, Zhang C, et al. Efficacy of alprostadil in preventing contrast-induced nephropathy: a systematic review and meta-Analysis. Angiology, 2021, 72(9): 878-888.
25.	Hu MJ, Luo EF, Tang CC, et al. Meta-analysis of the effects of furosemide combined with hydration therapy on contrast-induced acute kidney injury after coronary intervention. Eur Rev Med Pharmacol Sci, 2021, 25(14): 4729-4737.
26.	Martha JW, Pranata R, Wibowo A, et al. The effect of trimetazidine on contrast-induced nephropathy in patients undergoing coronary angiography and/or percutaneous coronary intervention - a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci, 2021, 25(7): 3045-3053.
27.	李思淼, 梁宇, 趙春陽, 等. 普羅布考預防對比劑腎病的Meta分析. 藥物評價研究, 2019, 42(8): 1637-1643.
28.	巴文強, 李艷, 陳力群, 等. 腦利鈉肽預防造影劑腎病療效的meta分析. 中南藥學, 2021, 19(2): 338-345.
29.	Prasad A, Sohn A, Morales J, et al. Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists. Catheter Cardiovasc Interv, 2017, 89(3): 383-392.
30.	樊澤元, 季漢華. 曲美他嗪對腎功能不全患者冠脈介入術后造影劑腎病的預防作用. 實用醫學雜志, 2017, 33(15): 2558-2562.
31.	Fragasso G, Rosano G, Baek SH, et al. Effect of partial fatty acid oxidation inhibition with trimetazidine on mortality and morbidity in heart failure: results from an international multicentre retrospective cohort study. Int J Cardiol, 2013, 163(3): 320-325.
32.	Zhang Q, Chen L, Si Z, et al. Probucol protects endothelial progenitor cells against oxidized low-density lipoprotein via suppression of reactive oxygen species formation in vivo. Cell Physiol Biochem, 2016, 39(1): 89-101.
33.	索新祺, 楊世誠, 馬振華, 等. 普羅布考對冠心病患者介入治療術后對比劑腎病的預防作用. 中華醫學雜志, 2017, 97(41): 3234-3238.
34.	張彩香, 渠風琴, 韓重陽. 大鼠糖尿病造影劑腎病中中性粒細胞明膠酶相關脂質運載蛋白的表達水平及普羅布考的保護作用. 中華生物醫學工程雜志, 2019, 25(1): 36-41.
35.	Solomon R. Forced diuresis with the RenalGuard system: impact on contrast induced acute kidney injury. J Cardiol, 2014, 63(1): 9-13.
36.	Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA, 2004, 291(19): 2328-2334.
37.	陳鵬, 牛琳琳, 朱明軍, 等. 中藥對冠脈介入術后造影劑腎病防治的作用機制淺析. 中國中西醫結合雜志, 2016, 36(8): 991-993.
38.	李逸雯, 劉艷飛, 崔京, 等. 冠心病中醫藥診療指南的方法學質量評價. 中國循證醫學雜志, 2021, 21(6): 696-702.
39.	Shojania KG, Sampson M, Ansari MT, et al. How quickly do systematic reviews go out of date: a survival analysis. Ann Intern Med, 2007, 147(4): 224-233.

1. Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation, 2021, 143(8): e254-e743.
2. 中國心血管健康與疾病報告編寫組. 中國心血管健康與疾病報告2020概要. 中國循環雜志, 2021, 36(6): 521-545.
3. 中華醫學會心血管病學分會介入心臟病學組, 中華醫學會心血管病學分會大血管病學組, 中華心血管病雜志編輯委員會. 經動脈心血管介入診治中含碘對比劑相關不良反應防治的中國專家共識(2021). 中華心血管病雜志, 2021, 49(10): 972-985.
4. Lun Z, Liu L, Chen G, et al. The global incidence and mortality of contrast-associated acute kidney injury following coronary angiography: a meta-analysis of 1. 2 million patients. J Nephrol, 2021, 34(5): 1479-1489.
5. Bei W, Li H, Lin K, et al. Post-Hoc Study: intravenous hydration treatment in Chinese patients with high risk of contrast-induced nephropathy following percutaneous coronary intervention. Sci Rep, 2017, 7: 45023.
6. Su X, Xie X, Liu L, et al. Comparative effectiveness of 12 treatment strategies for preventing contrast-induced acute kidney injury: a systematic review and Bayesian network meta-analysis. Am J Kidney Dis, 2017, 69(1): 69-77.
7. Giacoppo D, Gargiulo G, Buccheri S, et al. Preventive strategies for contrast-induced acute kidney injury in patients undergoing percutaneous coronary procedures: evidence from a hierarchical Bayesian network meta-analysis of 124 trials and 28 240 patients. Circ Cardiovasc Interv, 2017, 10(5): e004383.
8. 中華醫學會放射學分會質量控制與安全管理專業委員會. 腎病患者靜脈注射碘對比劑應用專家共識. 中華放射學雜志, 2021, 55(6): 580-590.
9. 高洪陽, 趙陽, 高蕊, 等. Cochrane Overview的研究現狀及制作方法調查. 中國循證醫學雜志, 2014, 14(12): 1514-1519.
10. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339: b2535.
11. 王靖, 劉琴, 翁淳光, 等. 國內公共衛生研究領域系統評價/Meta分析的質量評價. 中國循證醫學雜志, 2010, 10(12): 1367-1374.
12. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
13. 張方圓, 沈傲梅, 曾憲濤, 等. 系統評價方法學質量評價工具AMSTAR 2解讀. 中國循證心血管醫學雜志, 2018, 10(1): 14-18.
14. 陳耀龍, 姚亮, Susan Norris, 等. GRADE在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
15. 李婷, 弓旭東, 張雪峰, 等. 他汀預防心臟介入手術患者造影劑腎病的Meta分析. 中國循證醫學雜志, 2015, 15(11): 1277-1283.
16. Wang N, Qian P, Kumar S, et al. The effect of N-acetylcysteine on the incidence of contrast-induced kidney injury: a systematic review and trial sequential analysis. Int J Cardiol, 2016, 209: 319-327.
17. 張斌, 梁龍, 陳文波, 等. 碳酸氫鈉預防對比劑腎病療效的Meta分析. 臨床放射學雜志, 2015, 34(7): 1152-1158.
18. 齊春霞, 吳偉, 褚慶民, 等. 丹紅注射液聯合水化預防造影劑腎病療效的系統評價與Meta分析. 中西醫結合心腦血管病雜志, 2017, 15(5): 570-573.
19. 唐庚, 馬根山. 維生素預防冠狀動脈造影術后對比劑腎病的Meta分析. 中國循環雜志, 2018, 33(2): 181-186.
20. 習元堂, 袁麗宜, 徐思婷, 等. 丹參多酚酸鹽靜脈滴注聯合水化預防造影劑腎病療效的Meta分析. 中國中藥雜志, 2019, 44(12): 2616-2626.
21. Zang H, Zhang Q, Li X. Adenosine antagonists for prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials with trial sequential analysis. Exp Ther Med, 2019, 18(1): 85-98.
22. Pranata R, Vania R, Alkatiri AA, et al. Nicorandil reduces the incidence of contrast-induced nephropathy in patients undergoing coronary angiography/intervention-systematic review and meta-analysis of randomized controlled trials including GRADE qualification. Cardiovasc Revasc Med, 2020, 21(9): 1121-1127.
23. 馬光, 王國良, 侯德和, 等. 別嘌呤醇聯合水化對冠狀動脈介入術后造影劑腎病預防作用的Meta分析. 中國循證心血管醫學雜志, 2020, 12(7): 788-793.
24. Xu H, Wang H, Zhang C, et al. Efficacy of alprostadil in preventing contrast-induced nephropathy: a systematic review and meta-Analysis. Angiology, 2021, 72(9): 878-888.
25. Hu MJ, Luo EF, Tang CC, et al. Meta-analysis of the effects of furosemide combined with hydration therapy on contrast-induced acute kidney injury after coronary intervention. Eur Rev Med Pharmacol Sci, 2021, 25(14): 4729-4737.
26. Martha JW, Pranata R, Wibowo A, et al. The effect of trimetazidine on contrast-induced nephropathy in patients undergoing coronary angiography and/or percutaneous coronary intervention - a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci, 2021, 25(7): 3045-3053.
27. 李思淼, 梁宇, 趙春陽, 等. 普羅布考預防對比劑腎病的Meta分析. 藥物評價研究, 2019, 42(8): 1637-1643.
28. 巴文強, 李艷, 陳力群, 等. 腦利鈉肽預防造影劑腎病療效的meta分析. 中南藥學, 2021, 19(2): 338-345.
29. Prasad A, Sohn A, Morales J, et al. Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists. Catheter Cardiovasc Interv, 2017, 89(3): 383-392.
30. 樊澤元, 季漢華. 曲美他嗪對腎功能不全患者冠脈介入術后造影劑腎病的預防作用. 實用醫學雜志, 2017, 33(15): 2558-2562.
31. Fragasso G, Rosano G, Baek SH, et al. Effect of partial fatty acid oxidation inhibition with trimetazidine on mortality and morbidity in heart failure: results from an international multicentre retrospective cohort study. Int J Cardiol, 2013, 163(3): 320-325.
32. Zhang Q, Chen L, Si Z, et al. Probucol protects endothelial progenitor cells against oxidized low-density lipoprotein via suppression of reactive oxygen species formation in vivo. Cell Physiol Biochem, 2016, 39(1): 89-101.
33. 索新祺, 楊世誠, 馬振華, 等. 普羅布考對冠心病患者介入治療術后對比劑腎病的預防作用. 中華醫學雜志, 2017, 97(41): 3234-3238.
34. 張彩香, 渠風琴, 韓重陽. 大鼠糖尿病造影劑腎病中中性粒細胞明膠酶相關脂質運載蛋白的表達水平及普羅布考的保護作用. 中華生物醫學工程雜志, 2019, 25(1): 36-41.
35. Solomon R. Forced diuresis with the RenalGuard system: impact on contrast induced acute kidney injury. J Cardiol, 2014, 63(1): 9-13.
36. Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA, 2004, 291(19): 2328-2334.
37. 陳鵬, 牛琳琳, 朱明軍, 等. 中藥對冠脈介入術后造影劑腎病防治的作用機制淺析. 中國中西醫結合雜志, 2016, 36(8): 991-993.
38. 李逸雯, 劉艷飛, 崔京, 等. 冠心病中醫藥診療指南的方法學質量評價. 中國循證醫學雜志, 2021, 21(6): 696-702.
39. Shojania KG, Sampson M, Ansari MT, et al. How quickly do systematic reviews go out of date: a survival analysis. Ann Intern Med, 2007, 147(4): 224-233.

Chinese Journal of Evidence-Based Medicine

Efficacy of different pharmacological interventions in the prevention of contrast-induced acute kidney injury after percutaneous coronary intervention: an overview of systematic reviews

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content