Background: Different methods to prevent contrast-associated acute kidney injury (CA-AKI) have been proposed in recent years. We performed a mixed treatment comparison to evaluate and rank suggested interventions.
Methods: A comprehensive Systematic review and a Bayesian network meta-analysis of randomised controlled trials was completed. Results were tabulated and graphically represented using a network diagram; forest plots and league tables were shown to rank treatments by the surface under the cumulative ranking curve (SUCRA). A stacked bar chart rankogram was generated. We performed main analysis with 200 RCTs and three analyses according to contrast media and high or normal baseline renal profile that includes 173, 112 & 60 RCTs respectively.
Results: We have included 200 trials with 42,273 patients and 44 interventions. The primary outcome was CI-AKI, defined as ≥25% relative increase or ≥ 0.5 mg/dl increase from baseline creatinine one to 5 days post contrast exposure. The top ranked interventions through different analyses were Allopurinol, Prostaglandin E1 (PGE1) & Oxygen (0.9647, 0.7809 & 0.7527 in the main analysis). Comparatively, reference treatment intravenous hydration was ranked lower but better than Placebo (0.3124 VS 0.2694 in the main analysis).
Conclusion: Multiple CA-AKI preventive interventions have been tested in RCTs. This network evaluates data for all the explored options. The results suggest that some options (particularly allopurinol, PGE1 & Oxygen) deserve further evaluation in a larger well-designed RCTs.
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http://dx.doi.org/10.1186/s12882-018-1113-0 | DOI Listing |
Eur J Trauma Emerg Surg
January 2025
Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan.
Purpose: This study investigates the risk of contrast-associated acute kidney injury (CA-AKI) in trauma patients, focusing on the impact of cumulative contrast medium doses.
Methods: A retrospective review was conducted at a level 1 trauma center (2019-2021). The study included patients who underwent intravascular contrast-enhanced examinations for torso trauma within 7 days post-injury.
Artif Organs
January 2025
International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy.
Background: Contrast-associated acute kidney injury (CA-AKI) is frequent in patients with chronic kidney disease who are submitted to cardiac endovascular procedures using iodinated contrast. In hemoadsorption, cartridges containing styrene-divinylbenzene sorbent resin are applied to remove substances from the blood through an extracorporeal circuit. Importantly, iodinated contrast is also removed via adsorption.
View Article and Find Full Text PDFHeliyon
January 2025
Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Background: Dynamic Coronary Roadmap (DCR) is a new PCI method that may reduce contrast dose and contrast-associated acute kidney injury (CA-AKI) risk. This paper evaluates DCR-guided PCI versus standard angiography PCI for contrast usage, procedure time, and CA-AKI risk.
Methods: On May 1, 2024, we searched PubMed, Scopus, Embase, Cochrane Library, and clinicaltrials.
Am J Cardiol
January 2025
Research Unit of Cardiac Sciences, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
Contrast-associated acute kidney injury (CA-AKI) remains a serious complication after percutaneous coronary revascularization (PCI), with limited effective preventive strategies especially for diabetic patients. This study aimed to assess the effects of novel antidiabetic agents (NAD), i.e.
View Article and Find Full Text PDFBMC Nephrol
January 2025
Department of Internal Medicine II, Universitätsmedizin (Halle), Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.
Background: Managing acute myocardial infarction (AMI) in patients with chronic kidney disease (CKD) or end-stage renal disease on dialysis (renal replacement therapy, RRT) presents challenges due to elevated complication risks. Concerns about contrast-related kidney damage may lead to the omission of guideline-directed therapies like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in this population.
Methods: We analysed German-DRG data of 2016 provided by the German Federal Bureau of Statistics (DESTATIS).
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