Abstract | BACKGROUND: METHODS: We did a meta-analysis of randomised controlled trials comparing acetylcysteine and hydration with hydration alone for preventing contrast nephropathy in patients with chronic renal insufficiency. The trials were identified through a combined search of the BIOSIS+/RRM, MEDLINE, Web of Science, Current Contents Medizin, and The Cochrane Library Databases. We used incidence of contrast nephropathy 48 h after administration of radiocontrast media as an outcome measure. FINDINGS: Seven trials including 805 patients were eligible according to our inclusion criteria and were analysed. Overall incidence of contrast nephropathy varied between 8% and 28%. Since significant heterogeneity was indicated by the Q statistics (p=0.016) we used a random-effects model to combine the data. Compared with periprocedural hydration alone, administration of acetylcysteine and hydration significantly reduced the relative risk of contrast nephropathy by 56% (0.435 [95% CI 0.215-0.879], p=0.02) in patients with chronic renal insufficiency. Meta-regression revealed no significant relation between the relative risk of contrast nephropathy and the volume of radiocontrast media administered or the degree of chronic renal insufficiency before the procedure. INTERPRETATION:
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Authors | Rainer Birck, Stefan Krzossok, Florian Markowetz, Peter Schnülle, Fokko J van der Woude, Claude Braun |
Journal | Lancet (London, England)
(Lancet)
Vol. 362
Issue 9384
Pg. 598-603
(Aug 23 2003)
ISSN: 1474-547X [Electronic] England |
PMID | 12944058
(Publication Type: Comparative Study, Journal Article, Meta-Analysis)
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Chemical References |
- Contrast Media
- Cysteine
- Acetylcysteine
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Topics |
- Acetylcysteine
(therapeutic use)
- Acute Kidney Injury
(blood, chemically induced, epidemiology)
- Aged
- Contrast Media
(adverse effects)
- Cysteine
(blood)
- Female
- Humans
- Kidney Failure, Chronic
(epidemiology)
- Male
- Middle Aged
- Outcome Assessment, Health Care
- Radiography
(adverse effects)
- Randomized Controlled Trials as Topic
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