Meta-analysis of effect of renin-angiotensin-aldosterone system blockers on contrast-induced nephropathy.

IF 2.1 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Journal of the Renin-Angiotensin-Aldosterone System Pub Date : 2020-04-01 DOI:10.1177/1470320320919587

Weidong Wang, Wei Qu, Dan Sun, Xiaodan Liu

{"title":"Meta-analysis of effect of renin-angiotensin-aldosterone system blockers on contrast-induced nephropathy.","authors":"Weidong Wang, Wei Qu, Dan Sun, Xiaodan Liu","doi":"10.1177/1470320320919587","DOIUrl":null,"url":null,"abstract":"Background: The purpose of this study was to systematically evaluate the effect of renin-angiotensin-aldosterone system blockers on the incidence of contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention.Methods: A systematic literature search of several databases was conducted to identify studies that met the inclusion criteria. A total of 12 studies with 14 trials that performed studies on a total of 4864 patients (2484 treated with renin-angiotensin-aldosterone system blockers and 2380 in the control group) were included. The primary endpoint was the overall incidence of contrast-induced nephropathy. Analyses were performed with STATA version 12.0.Results: The overall contrast-induced nephropathy incidence in renin-angiotensin-aldosterone system blocker and control groups was 10.43% and 6.81%, respectively. The pooled relative risk of contrast-induced nephropathy incidence was 1.22 (95% confidence interval: 0.81-1.84) in the renin-angiotensin-aldosterone system blocker group. An increased risk of developing contrast-induced nephropathy in the renin-angiotensin-aldosterone system blocker group was observed among older people, non-Asians, chronic users, and studies with larger sample size, and the pooled RRs and 95% confidence intervals were 2.02 (1.21-3.36), 2.30 (1.41-3.76), 1.69 (1.10-2.59) and 1.83 (1.28-2.63), respectively.Conclusions: Intervention with renin-angiotensin-aldosterone system blockers was associated with an increased risk of contrast-induced nephropathy among non-Asians, chronic users, older people, and studies with larger sample size. Large clinical trials with strict inclusion criteria are needed to confirm our results and to evaluate the effect further.","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 2","pages":"1470320320919587"},"PeriodicalIF":2.1000,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320919587","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Renin-Angiotensin-Aldosterone System","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/1470320320919587","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 5

Abstract

Background: The purpose of this study was to systematically evaluate the effect of renin-angiotensin-aldosterone system blockers on the incidence of contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention.

Methods: A systematic literature search of several databases was conducted to identify studies that met the inclusion criteria. A total of 12 studies with 14 trials that performed studies on a total of 4864 patients (2484 treated with renin-angiotensin-aldosterone system blockers and 2380 in the control group) were included. The primary endpoint was the overall incidence of contrast-induced nephropathy. Analyses were performed with STATA version 12.0.

Results: The overall contrast-induced nephropathy incidence in renin-angiotensin-aldosterone system blocker and control groups was 10.43% and 6.81%, respectively. The pooled relative risk of contrast-induced nephropathy incidence was 1.22 (95% confidence interval: 0.81-1.84) in the renin-angiotensin-aldosterone system blocker group. An increased risk of developing contrast-induced nephropathy in the renin-angiotensin-aldosterone system blocker group was observed among older people, non-Asians, chronic users, and studies with larger sample size, and the pooled RRs and 95% confidence intervals were 2.02 (1.21-3.36), 2.30 (1.41-3.76), 1.69 (1.10-2.59) and 1.83 (1.28-2.63), respectively.

Conclusions: Intervention with renin-angiotensin-aldosterone system blockers was associated with an increased risk of contrast-induced nephropathy among non-Asians, chronic users, older people, and studies with larger sample size. Large clinical trials with strict inclusion criteria are needed to confirm our results and to evaluate the effect further.

Abstract Image

查看原文本刊更多论文

肾素-血管紧张素-醛固酮系统阻滞剂对造影剂肾病疗效的meta分析。

背景:本研究的目的是系统评价肾素-血管紧张素-醛固酮系统阻滞剂对冠脉造影或经皮冠状动脉介入治疗患者造影剂肾病发生率的影响。方法:对多个数据库进行系统的文献检索，以确定符合纳入标准的研究。共纳入了12项研究，14项试验，共对4864名患者进行了研究(2484名患者接受肾素-血管紧张素-醛固酮系统阻滞剂治疗，2380名患者为对照组)。主要终点是造影剂肾病的总发病率。使用STATA 12.0版本进行分析。结果:肾素-血管紧张素-醛固酮系统阻滞剂组和对照组造影剂肾病总发生率分别为10.43%和6.81%。在肾素-血管紧张素-醛固酮系统阻滞剂组，对比剂肾病发生率的总相对危险度为1.22(95%可信区间:0.81-1.84)。在老年人、非亚洲人、慢性使用者和样本量较大的研究中，肾素-血管紧张素-醛固酮系统阻滞剂组发生对比剂肾病的风险增加，合并rr和95%置信区间分别为2.02(1.21-3.36)、2.30(1.41-3.76)、1.69(1.10-2.59)和1.83(1.28-2.63)。结论:肾素-血管紧张素-醛固酮系统阻滞剂干预与非亚洲人、慢性使用者、老年人和样本量较大的研究中造影剂肾病的风险增加相关。需要有严格纳入标准的大型临床试验来证实我们的结果并进一步评估效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of the Renin-Angiotensin-Aldosterone System 医学-外周血管病

CiteScore

6.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.