Abstract
Contrast-induced nephropathy (CIN) has become the third-leading cause of hospital-acquired acute renal injury. Although alprostadil has been proposed as an effective preventative measure, this conclusion remains inconsistent. Thus, we performed a meta-analysis of the published studies on this topic to evaluate the preventative effect of alprostadil on CIN. Databases, including PubMed, the Web of Science, Cochrane Library, Wanfang, the China Biological Medicine Database (SinoMed) and the China National Knowledge Infrastructure (CNKI) were systematically searched. Nineteen clinical trials involving 2267 individuals were identified. We utilized a random or a fixed effect model to calculate the pooled odd ratios (ORs) and the standardized mean differences (SMD), respectively. Compared to the control group, the CIN risk decreased significantly in the alprostadil group (P < 0.00001, OR = 0.29, 95% CI = 0.21–0.39). In the subgroup of coronary angiography patients, the use of alprostadil also decreased the risk of CIN (P < 0.00001, OR = 0.27, 95% CI: 0.19–0.39). In conclusion, Alprostadil might be associated with a significant reduction in postcontrast Scr, BUN and CysC level and decrease the incidence of CIN.
Highlights
Contrast-induced nephropathy (CIN) has become the third-leading cause of hospital-acquired acute renal injury
After duplicates and preliminary screening of the article titles and abstracts, 31 studies were considered of interest, these articles was retrieved for further evaluation
The results showed that the postprocedural cystatin C (CysC) level significantly decreased in the alprostadil group compared with the non-alprostadil group (P = 0.02, standardized mean differences (SMD) = −0.54, 95% confidence interval (CI) = −1.01, −0.08)
Summary
Contrast-induced nephropathy (CIN) has become the third-leading cause of hospital-acquired acute renal injury. We performed a meta-analysis of the published studies on this topic to evaluate the preventative effect of alprostadil on CIN. With the development of radiography and the wide application of interventional therapy, the incidence of contrast-induced nephropathy (CIN) has become a serious clinical problem in the recent years. It has been turned into the third-leading cause of hospital-acquired acute renal injury[1, 2]. Franz RW et al.[11] designed a prospective, randomized, double blind study on 41 patients in 2011 and confirmed that oral PGE1 can reduce the incidence of CIN and decrease Scr levels significantly. We performed a meta-analysis of the existing published data on this topic to evaluate the strength of the association
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