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BMC Nephrology
Published in: BMC Nephrology 1/2018

Open Access 01-12-2018 | Research article

Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis

Authors: Khalid Ahmed, Terri McVeigh, Raminta Cerneviciute, Sara Mohamed, Mohammad Tubassam, Mohammad Karim, Stewart Walsh

Published in: BMC Nephrology | Issue 1/2018

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Abstract

Background

Different methods to prevent contrast-associated acute kidney injury (CA-AKI) have been proposed in recent years. We performed a mixed treatment comparison to evaluate and rank suggested interventions.

Methods

A comprehensive Systematic review and a Bayesian network meta-analysis of randomised controlled trials was completed. Results were tabulated and graphically represented using a network diagram; forest plots and league tables were shown to rank treatments by the surface under the cumulative ranking curve (SUCRA). A stacked bar chart rankogram was generated. We performed main analysis with 200 RCTs and three analyses according to contrast media and high or normal baseline renal profile that includes 173, 112 & 60 RCTs respectively.

Results

We have included 200 trials with 42,273 patients and 44 interventions. The primary outcome was CI-AKI, defined as ≥25% relative increase or ≥ 0.5 mg/dl increase from baseline creatinine one to 5 days post contrast exposure. The top ranked interventions through different analyses were Allopurinol, Prostaglandin E1 (PGE1) & Oxygen (0.9647, 0.7809 & 0.7527 in the main analysis). Comparatively, reference treatment intravenous hydration was ranked lower but better than Placebo (0.3124 VS 0.2694 in the main analysis).

Conclusion

Multiple CA-AKI preventive interventions have been tested in RCTs. This network evaluates data for all the explored options. The results suggest that some options (particularly allopurinol, PGE1 & Oxygen) deserve further evaluation in a larger well-designed RCTs.
Appendix
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Metadata
Title
Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis
Authors
Khalid Ahmed
Terri McVeigh
Raminta Cerneviciute
Sara Mohamed
Mohammad Tubassam
Mohammad Karim
Stewart Walsh
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2018
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-018-1113-0

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New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

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