Key result
Alprostadil reduces CIN incidence by ~71% versus control.
Why the study?
The preventative effect of alprostadil on contrast-induced nephropathy remains inconsistent and requires evaluation through meta-analysis.
Does alprostadil prevent contrast-induced nephropathy in patients receiving contrast media?
Meta-Analysis (n=2,267)
Does alprostadil prevent contrast-induced nephropathy in patients receiving contrast media?
Alprostadil may be an effective preventative measure for reducing the incidence of contrast-induced nephropathy and improving renal biomarkers following contrast exposure.
Alprostadil may warrant consideration to prevent contrast-induced nephropathy; confirms benefit in meta-analysis of prior trials.
Contrast-induced nephropathy (CIN) has become the third-leading cause of hospital-acquired acute renal injury. Although alprostadil has been proposed as an effective preventative measure, this conclusion remains inconsistent. Thus, we performed a meta-analysis of the published studies on this topic to evaluate the preventative effect of alprostadil on CIN. Databases, including PubMed, the Web of Science, Cochrane Library, Wanfang, the China Biological Medicine Database (SinoMed) and the China National Knowledge Infrastructure (CNKI) were systematically searched. Nineteen clinical trials involving 2267 individuals were identified. We utilized a random or a fixed effect model to calculate the pooled odd ratios (ORs) and the standardized mean differences (SMD), respectively. Compared to the control group, the CIN risk decreased significantly in the alprostadil group (P < 0.00001, OR = 0.29, 95% CI = 0.21-0.39). In the subgroup of coronary angiography patients, the use of alprostadil also decreased the risk of CIN (P < 0.00001, OR = 0.27, 95% CI: 0.19-0.39). In conclusion, Alprostadil might be associated with a significant reduction in postcontrast Scr, BUN and CysC level and decrease the incidence of CIN.
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Zhang et al. (2017) conducted a meta-analysis in Contrast-induced nephropathy (n=2,267). Alprostadil vs. Control (non-alprostadil) was evaluated on Incidence of contrast-induced nephropathy (CIN) (OR 0.29, 95% CI 0.21-0.39, p=<0.00001). Alprostadil significantly reduced the incidence of contrast-induced nephropathy compared to the control group (OR 0.29).
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