Statin therapy reduces contrast-induced nephropathy: An analysis of contemporary percutaneous interventions

Khanal, Sanjaya; Attallah, Nizar; Smith, Dean E.; Kline–Rogers, Eva; Share, David; O’Donnell, Michael J.; Moscucci, Mauro

doi:10.1016/j.amjmed.2005.03.031

Cited by 177 publications

(105 citation statements)

References 25 publications

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“…The main characteristics of the cohort studies are listed in table 1[18,19,20,21,22,23]. The definition of CIN as an increase in serum creatinine >25% or 0.5 mg/dl was used in 4 studies, and the other 2 studies used serum creatinine >0.5 mg/dl as a definition.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, Khanal et al [20] reported a significant reduction in the need for renal dialysis in the statin group (0.32 vs. 0.49%, p = 0.03). In the study by Patti et al [23], 430 of 434 patients (99%) were followed up for 4 years, and no patient required dialysis.…”

Section: Resultsmentioning

confidence: 99%

“…But there were still some confounding variables. For instance, there was a higher percentage of patients with diabetes mellitus or chronic heart failure in the statin group than in the statin-naïve group in the study by Khanal et al [20]. In the study by Kandula [19], the mean total contrast dose per procedure in the statin group was more than that in the statin-naïve group.…”

Section: Discussionmentioning

confidence: 99%

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Statins for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

Zhang

Shen²,

Hu³

et al. 2011

Am J Nephrol

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Background: Retrospective and prospective studies have demonstrated that statins have a protective effect in preventing contrast-induced nephropathy (CIN), but there are currently no established guidelines for statin timing or dosage. A systematic review and meta-analysis was performed to determine whether statin administration is protective and the magnitude of their effect. Methods: We searched MEDLINE, EMBASE, Cochrane Library, CNKI and ISI Proceedings for cohort studies comparing the CIN incidence in a chronic statin pretreatment group and a statin-naïve group, as well as for randomized controlled trials (RCTs) comparing short-term high-dose to short-term low-dose statin treatment or placebo. CIN was defined as an increase in serum creatinine >25% or 0.5 mg/dl (44.2 µmol/l). Qualitative analysis of cohort studies and quantitative analysis of RCTs to estimate pooled risk ratios were performed. Results: Among 6 cohort studies, 4 showed chronic statin pretreatment had a preventive effect against CIN. From 6 RCTs, 1,194 patients were included in the meta-analysis. Under the fixed-effects model, a nonsignificant protective trend toward decreased incidence of CIN with periprocedural short-term high-dose statin treatment was seen (RR: 0.70; 95% CI: 0.48–1.02). Conclusion: Current data are not conclusive to whether statins are protective for CIN due to the inherent limitations of the included studies. In the future, large well-designed studies are needed to address the effect of this drug and its longer-term clinical outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Statins for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

Zhang

Shen²,

Hu³

et al. 2011

Am J Nephrol

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“…The role of dyslipidemia in the development of CIN is not clear. Previous studies showed inconsistent results [72,73,74,75]. However, Patti et al [76 ]showed, by means of the ARMYDA-CIN trial, that CIN incidence was reduced by treatment with statins.…”

Section: Risk Factors For Cinmentioning

confidence: 99%

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Aurelio¹,

Durante²

2014

Cardiology

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Contrast-induced nephropathy (CIN) is a well-known adverse event of therapeutic and diagnostic procedures requiring the adminstration of contrast medium (CM). The lack of a universal CIN definition and glomerular filtration rate markers that vary have resulted in a variety of reported incidences. The development of CIN is associated with an increase in the length of hospital stay and the risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure and the volume of CM administered are all associated with a risk for developing CIN. The literature suggests the use of low-osmolarity CM and supports volume supplementation before administration. Moreover, other strategies to avoid CIN, including treatment with N-acetylcisteine and sodium bicarbonate have variable levels of evidence. This review examines the main components of the pathogenesis and risk factors of CIN and possible preventive measures and therapies.

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“…Therefore, the vast majority of patients should be on statin therapy with a common low-density lipoprotein cholesterol (LDL-C) target of <70 mg/dl. It has been demonstrated that patients continued on statins during cardiovascular procedures including PCI and CABG have lower rates of AKI [80]. Small randomized trials published to date support this concept as well [81, 82].…”

Section: Pharmacologic Prophylaxismentioning

confidence: 99%

Radiocontrast-Induced Acute Kidney Injury

McCullough¹

2008

Nephron Physiol

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Many radiographic studies and procedures use iodinated contrast media and consequently pose the risk of contrast-induced acute kidney injury (AKI). This is an important complication, which accounts for a significant number of cases of hospital-acquired renal failure associated increased hospital length of stay and increased mortality. Sustained reductions in renal blood flow, hypoxic injury, direct cellular toxicity by the contrast media, and superimposed organ injury are all believed to play a role in this form of AKI. Avoidance of dehydration and multimodality prevention measures may reduce rates of this problem in patients at risk. Contrast-induced AKI is likely to remain a significant challenge for specialists in the future since the patient population is aging, chronic kidney disease and diabetes are coming more common, and use of iodinated contrast is growing.

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Statin therapy reduces contrast-induced nephropathy: An analysis of contemporary percutaneous interventions

Cited by 177 publications

References 25 publications

Statins for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

Statins for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Radiocontrast-Induced Acute Kidney Injury

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