Renin-angiotensin system blockades and contrast-induced nephropathy: a meta-analysis
10.3760/cma.j.issn.1001-7097.2016.05.006
- VernacularTitle:肾素-血管紧张素系统阻滞剂与造影剂肾病发生的Meta分析
- Author:
Tinging ZHAI
;
Mengchun LIU
;
Xuemei LIU
;
Yan XU
;
Liqiu LIU
- Publication Type:Journal Article
- Keywords:
Angiotensin converting enzyme inhibitors;
Angiotensin Ⅱ type 1 receptor blockers;
Angiography;
Contrast media;
Kidney disease;
Meta-analysis
- From:
Chinese Journal of Nephrology
2016;32(5):350-357
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of renin-angiotensin system (RAS) blockades [angiotensin-converting enzyme inhibitors (ACEI) and angiotensin Ⅱ type 1 receptor blockers (ARB)]on contrast-induced nephropathy (CIN) in patients undergoing angiography.Methods Pubmed,Embase,Cochrane library,Wanfang database and CNKI were searched.The literature limited range was from their start year to July 2015.Randomized controlled trials (RCTs) and non-randomized controlled trials of renin-angiotensin system blockades in influencing CIN were assessed.Two investigators extracted data and performed quality analysis independently from all trims included.Rev man 5.3 software was used.Results 16 trials with a total of 15 897 patients were identified.There were 7490 patients who received renin-angiotensin system blockades and 8407 patients in control group.The meta analysis revealed a higher CIN incidence in ACEI/ARB group than that in control group (14.35% vs 12.13%,P=0.04,OR=1.44,95%CI 1.01-2.04).For patients with renal insufficiency,ACEI/ARB group had a higher CIN incidence than control group (12.23% vs 7.32%,P=0.02,OR=1.80,95%CI 1.10-2.94),and the serum creatinine changes in ACEI/ARB group were higher than those in control group.There was statistical difference in serum creatinine changes between groups (P=0.02,MD=0.08,95%CI 0.02-0.15).Conclusions Renin-angiotensin system blockades can increase theincidence of CIN in patients undergoing angiography.Renin-angiotensin system blockades can contribute to CIN for patients with renal insufficiency.