The studies investigated the predictive value of the contrast media volume to creatinine clearance ratio (V/CrCl) for contrast-induced nephropathy (CIN) after a percutaneous coronary intervention (PCI) showed conflicting results and different cut-off values. The objective is to evaluate V/CrCl in the prediction of CIN after PCI. PubMed, Embase, and the Cochrane library were searched for eligible studies published from inception to November 2020. The optimal cut-off points of V/CrCl for predicting CIN were examined using odds ratios (ORs) and 95% confidence intervals (CIs). The random-effect model was used for analyses. Six studies (8 datasets, 16 899 patients) were included. V/CrCl was associated with CIN (OR = 2.67, 95% CI: 1.88-3.78, < .001; I = 79.3%, < .001). V/CrCl was associated with CIN in Asians (OR = 2.13, 95% CI: 1.52-2.98, = .022; I = 68.8%, < .001) and Europeans (OR = 3.87, 95% CI: 1.77-8.45, < .001; I = 85.1%, = .001). The association between V/CrCl and CIN was observed in the prospective cohort studies (OR = 2.16, 95% CI: 1.42-3.29, = .009; I = 78.9%, < .001) and retrospective cohort studies (OR = 3.31, 95% CI: 1.82-6.02, < .001; I = 80.6%, < .001). The sensitivity analysis showed the results were robust. V/CrCl is independently associated with an increased risk of CIN. V/CrCl could be considered a reliable predictor for the development of CIN in patients undergoing PCI.
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