The Lack of Benefit of a Combination of an Angiotensin Receptor Blocker and Calcium Channel Blocker on Contrast-Induced Nephropathy in Patients with Chronic Kidney Disease

Oguzhan, Nilufer; Cilan, Havva; Sipahioğlu, Murat Hayri; Ünal, Aydın; Koçyiğit, İsmail; Kavuncuoğlu, Feridun; Arıkan, Tamer; Akpek, Mahmut; Elçik, Deniz; Şahin, Ömer; Gulme, Ebru; Pala, Çiğdem; Tokgöz, Bülent; Utaş, Cengiz; Oğuzhan, Abdurrahman; Oymak, Oktay

doi:10.3109/0886022x.2013.766566

Cited by 19 publications

(18 citation statements)

References 22 publications

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“…Besides, the study by Gupta et al [36] that recruited a randomized Indian population was regarded as an independent subgroup because its lineage was complicated and could not be simply grouped as Asian or Caucasian [44–46]. Seven studies received ACEIs, such as captopril and benazpril [15–17, 36, 37, 40, 41], 1 study received valsartan [38] and 6 studies received either ACEIs or ARBs [18, 19, 35, 39, 42, 43]. Seven random controlled trails (RCTs) were identified in the meta-analysis [15, 36–41], while the other 7 studies were observational studies (i.e.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Renin-Angiotensin-Aldosterone System Blockade Medications on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Meta-Analysis

Zhang

Jin

et al. 2015

PLoS ONE

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BackgroundContrast-induced nephropathy (CIN) is the main complication of contrast media administration (CM) in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). There are inconsistent results in the literature regarding the effect of renin-angiotensin-aldosterone system (RAAS) blockers (angiotensin-converting enzyme inhibitors [ACEIs] and angiotensin receptor blockers [ARBs]) on CIN. We evaluated the association between the administration of ACEI/ARBs and CIN, as well as the effect of ACEI/ARBs on post-procedural changes in renal function index, in patients undergoing CAG.MethodsWe searched Pubmed, EMBASE, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov for relevant studies. The primary search generated 893 potentially relevant articles. A total of 879 studies were excluded because they did not meet the selection criteria. Finally, 14 studies were eligible for inclusion. There were 7,288 patients that received ACEI/ARBs and 8,159 patients that received placebo or naive to ACEI/ARBs in the study. A random or a fixed effect model was used to calculate the pooled odd ratios (ORs).ResultsThe risk of CIN was significantly increased in the ACEI/ARBs group compared to the control group (OR= 1.50, 95%CI: 1.03-2.18, P =0.03). The magnitude of association was significantly reinforced in the observational studies (OR=1.84, 95%CI 1.19-2.85, P=0.006) but not in the randomized controlled trials (OR=0.88, 95%CI 0.41-1.90 P=0.74). The summary adjusted OR of 4 observational studies was 1.56 (95%CI 1.25-1.94, P<0.0001) and was weaker than the unadjusted OR.ConclusionsAlthough there is some evidence to suggest that the administration of RAAS blockers was associated with the increased risk of CIN in patients undergoing CAG, the robustness of our study remains weak. The results are based on small observational studies and need further validation.

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Section: Resultsmentioning

confidence: 99%

“…Of all the 7 RCTs, 2 studies were judged to be at low risk of bias [36, 37], 2 at high risk of bias [15, 39] and 3 had an unclear risk of bias [38, 40, 41]. As for the 7 observational studies, 6 studies (86%) scored 5 stars or more, suggesting a moderate to good quality.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Renin-Angiotensin-Aldosterone System Blockade Medications on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Meta-Analysis

Zhang

Jin

et al. 2015

PLoS ONE

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“…Oguzhan et al objected to the benefit of a combination of an ARB and CCB in the treatment of CI-AKI in 90 CKD patients, the incidence of CI-AKI in patients undergoing coronary angiography received hydration along with amlodipine/valsartan (n = 45) increased when comparing to controls (n = 45), 17.8% vs 6.7%. (Oguzhan et al, 2013) In another study, among a total of 60 patients, isotonic sodium chloride, sodium bicarbonate, and isotonic sodium chloride with diltiazem application showed the same effect in prevention of CI-AKI. (Beyazal et al, 2014) But the sample size of the researches above is small, so in this study, we launched a much larger cohort: 2,667 hypertensive patients participated.…”

Section: Discussionmentioning

confidence: 91%

Protective Effects of Amlodipine Pretreatment on Contrast-Induced Acute Kidney Injury And Overall Survival In Hypertensive Patients

Zhou

et al. 2020

Front. Pharmacol.

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Backgroud: Contrast-induced acute kidney injury (CI-AKI) is the most common adverse reaction caused by contrast media, which has been reported to prolong hospitalization and increase mortality and morbidity. The hypertensive population has proved susceptible to CI-AKI. Unfortunately, no therapeutic has been shown to prevent and cure CI-AKI effectively. A few studies have shown the protection of amlodipine on renal function, but the relationship between amlodipine and CI-AKI in hypertensive group is unknown, we aimed to study the effects of amlodipine on CI-AKI and overall survival in a large Chinese hypertensive cohort. Methods: A retrospective, matched, cohort study was conducted among adults hospitalized at the Third Xiangya Hospital of Central South University from October 2007 to May 2017. CI-AKI was the primary end point of the trial, time-related all-cause mortality (including in-hospital) and length of hospital stay were the secondary end points. Propensity Score Matching was used to reduce the effect of selection bias and potential confounding. Results: 868 patients with and 1,798 ones without amlodipine before contrast administration were included. The incidence of CI-AKI was 10.50%. The unadjusted, adjusted, and propensity-score matched incidence of CI-AKI were lower in patients treated with amlodipine (OR, 0.650; P = 0 .003; OR, 0.577; P = 0.007; OR, 0.687; P = 0.015, respectively), and the same results were found in the subgroups of diabetes, chronic kidney disease (CKD), non-CKD, low-osmolar, and elderly. Moreover, amlodipine reduced hospital stay, whether matched or not (7.08 ± 7.28 vs 7.77 ± 7.82, P = 0.027, before matching; vs 7.81 ± 7.58, P = 0.040, after matching). 1,046 patients finished follow-up including 343 amlodipine users and 703 non-users. The overall mortality was significantly lower among amlodipine users (10.79%) than controls (16.07%), the significant difference was found in survival between them (P = 0.024, log-rank test), amlodipine was associated with longer overall survival [HR, 0.623; 95% CI (0.430-0.908), P = 0.014]. Conclusion:In conclusion, we first found amlodipine treatment before contrast exposure played a role in protecting hypertensive patients from CI-AKI and prolonging survival.

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“…В эксперименте с острым повреждением почек показано, что после применения препаратов в ткани почек оказалось повышенным содержание супероксиддисмутазы и глутатионпероксидазы и пониженным -малоно-вого альдегида. Это свидетельствует о скрытых поло-жительных свойствах данной группы препаратов, за счёт которых создаётся положительный эффект их использования [10,11]. Сообщается также, что бло-каторы кальциевых каналов третьего поколения улучшают внутрипочечную гемодинамику.…”

Section: российский кардиологический журнал 2013; 2 (100): 65-68unclassified

Challenges in hypotensive therapy: the role of calcium antagonists

Таратухин¹,

Теплова²

2013

Russ J Cardiol

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The Lack of Benefit of a Combination of an Angiotensin Receptor Blocker and Calcium Channel Blocker on Contrast-Induced Nephropathy in Patients with Chronic Kidney Disease

Cited by 19 publications

References 22 publications

The Effect of Renin-Angiotensin-Aldosterone System Blockade Medications on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Meta-Analysis

The Effect of Renin-Angiotensin-Aldosterone System Blockade Medications on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Meta-Analysis

Protective Effects of Amlodipine Pretreatment on Contrast-Induced Acute Kidney Injury And Overall Survival In Hypertensive Patients

Challenges in hypotensive therapy: the role of calcium antagonists

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