Beneficial effect of statin on preventing contrast-induced acute kidney injury in patients with renal insufficiency A meta-analysisopen access
- Authors
- Cho, AJin; Lee, Young-Ki; Sohn, Seo Young
- Issue Date
- Mar-2020
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- acute kidney injury; contrast media; statin
- Citation
- MEDICINE, v.99, no.10, pp.1 - 8
- Indexed
- SCIE
SCOPUS
- Journal Title
- MEDICINE
- Volume
- 99
- Number
- 10
- Start Page
- 1
- End Page
- 8
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/146069
- DOI
- 10.1097/MD.0000000000019473
- ISSN
- 0025-7974
- Abstract
- Background:
Renal insufficiency is an important predictor of contrast-induced acute kidney injury (CI-AKI). We performed a meta-analysis to examine the effects of short-term statin therapy on the incidence of CI-AKI, particularly in patients with renal insufficiency.
Methods:
A systematic search was conducted to retrieve randomized controlled trials (RCTs) that investigated the impact of statin pretreatment before administration of contrast media on the development of CI-AKI in patients with mild to moderate renal insufficiency. The primary outcome was development of CI-AKI. The secondary outcome was the incidence ofacute kidney injury requiring hemodialysis.
Results:
Data analysis from 8 RCTs, which included a total of 2313 subjects in the statin-treated group and 2322 in the control group, showed that statin pretreatment was associated with significant reduction of the risk of CI-AKI (relative risk [RR] = 0.59; 95% confidential interval [CI] 0.44–0.79; P = .0003, I2 = 0%). A beneficial effect of statin on preventing CI-AKI was consistent, regardless of the dose of statin and use of N-acetylcysteine. In subgroup analysis based on baseline estimated glomerular filtration rate (eGFR), patients with baseline eGFR <60 mL/min/1.73 m2 (RR = 0.63; 95% CI 0.41–0.98; P = .04, I2 = 0%) and 30 < eGFR < 90 mL/min/1.73 m2 (RR = 0.56; 95% CI 0.39–0.82; P = .003, I2 = 0%) showed significant reduction of risk of CI-AKI.
Conclusion:
Statin pretreatment is effective at preventing CI-AKI and should be considered in patients with preexisting renal insufficiency.
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