Dataset Information

Additional furosemide treatment beyond saline hydration for the prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials.

ABSTRACT:

Objectives

There have been conflicting results on the clinical utility of furosemide in preventing contrast-induced nephropathy (CIN). This study aimed to elucidate the effect of additional furosemide treatment beyond saline hydration on CIN post radiologic procedures by a meta-analysis of randomized controlled trials (RCTs).

Methods

The Medline, EMBASE, and Cochrane databases were systematically searched. Two reviewers independently determined the eligibility of studies that randomly assigned patients undergoing radiologic procedure to receive additional peri-procedural furosemide injection or intravenous saline hydration alone. Combined results were presented as risk ratios (RR) with 95% confidence intervals (CI) by random-effect models.

Results

We identified 5 RCTs including 1330 patients. Of them 659 received peri-procedural furosemide injection in addition to saline hydration, and 671 only received intravenous saline hydration (the control). Relatively small total number of dialysis events and heart failure events were reported in the included studies (n = 18 across 5 trials, n = 24 across 3 trials, respectively). Compared to the control, additional furosemide treatment did not significantly increase the incidence of CIN (RR = 1.18; 95% CI, 0.50-2.78; P = 0.71) and the risk of dialysis (RR = 1.03; 95% CI, 0.41-2.57; P = 0.95) post radiologic procedure. Furthermore, furosemide treatment appeared to decrease the occurrence of heart failure (RR = 0.35; 95% CI, 0.14-0.88; P = 0.02).

Conclusions

Peri-procedural furosemide treatment in addition to saline hydration did not provide significantly prophylactic effect on CIN after radiologic procedure. Nevertheless, the process seemed likely to decrease the risk of heart failure post saline hydration.

SUBMITTER: Gu G

PROVIDER: S-EPMC4358464 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Additional furosemide treatment beyond saline hydration for the prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials.

Gu Guoqiang G Zhang Ying Y Lu Rui R Cui Wei W

International journal of clinical and experimental medicine 20150115 1

<h4>Objectives</h4>There have been conflicting results on the clinical utility of furosemide in preventing contrast-induced nephropathy (CIN). This study aimed to elucidate the effect of additional furosemide treatment beyond saline hydration on CIN post radiologic procedures by a meta-analysis of randomized controlled trials (RCTs).<h4>Methods</h4>The Medline, EMBASE, and Cochrane databases were systematically searched. Two reviewers independently determined the eligibility of studies that rand ...[more]

PMID: 25785009

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Project description:BackgroundContrast-induced nephropathy (CIN) is one of the common causes of acute renal insufficiency after contrast procedures. Whether intravenous N-acetylcysteine (NAC) is beneficial for the prevention of contrast-induced nephropathy is uncertain. In this meta-analysis of randomized controlled trials, we aimed to assess the efficacy of intravenous NAC for preventing CIN after administration of intravenous contrast media.Study designRelevant studies published up to September 2012 that investigated the efficacy of intravenous N-acetylcysteine for preventing CIN were collected from MEDLINE, OVID, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and the conference proceedings from major cardiology and nephrology meetings. The primary outcome was CIN. Secondary outcomes included renal failure requiring dialysis, mortality, and length of hospitalization. Data were combined using random-effects models with the performance of standard tests to assess for heterogeneity and publication bias. Meta-regression analyses were also performed.ResultsTen trials involving 1916 patients met our inclusion criteria. Trials varied in patient demographic characteristics, inclusion criteria, dosing regimens, and trial quality. The summary risk ratio for contrast-induced nephropathy was 0.68 (95% CI, 0.46 to 1.02), a nonsignificant trend towards benefit in patients treated with intravenous NAC. There was evidence of significant heterogeneity in NAC effect across studies (Q = 17.42, P = 0.04; I(2) = 48%). Meta-regression revealed no significant relation between the relative risk of CIN and identified differences in participant or study characteristics.ConclusionThis meta-analysis showed that research on intravenous N-acetylcysteine and the incidence of CIN is too inconsistent at present to warrant a conclusion on efficacy. A large, well designed trial that incorporates the evaluation of clinically relevant outcomes in participants with different underlying risks of CIN is required to more adequately assess the role for intravenous NAC in CIN prevention.

Dataset Information

Additional furosemide treatment beyond saline hydration for the prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials.

Objectives

Methods

Results

Conclusions

Publications

Additional furosemide treatment beyond saline hydration for the prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials.

Similar Datasets

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