• 作者：Estanislao Arana^a ; ^aranae@uv.es ; Ferrá ; n Catalá ; -Ló ; pez^b
• 关键词：Metaaná ; lisis ; Nefropatí ; a inducida por contraste ; Contraste yodado ; Tomografí ; a computarizada ; Enfermedad renal ; Insuficiencia renal
• 刊名：Medicina Cl铆nica
• 出版年：2010
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：11 September 2010
• 卷：135
• 期：8
• 页码：343-350
• 文件大小：249 K

Background and objective

We evaluated and quantified by meta-analysis techniques the incidence of contrast-induced nephropathy (CIN) in patients at risk undergoing computed tomography (CT).

Material and methods

We conducted a systematic review of randomized controlled clinical trials designated to evaluate the nephrotoxicity related to iso-osmolar contrast media (IOCM) compared to low-osmolar contrast media (LOCM). Main electronic databases searched included PubMed/MEDLINE, EMBASE, ISI Web of Knowledge and Virtual Health Library (BVS-BIREME), as well as abstracts presented at related scientific societies meetings. Prior to data extraction, definitions of nephrotoxicity and risk population were established. Besides meta-analysis, the global agreement between CIN definitions was evaluated with Mantel-Haenszel stratified test.

Results

Five studies were included with 716 randomized patients. When CIN was defined as increased serum creatinine (SCr) 鈮?5%, the relative risk (RR) was 0.71 (CI95%: 0.40鈥?.26)鈥搃n favor of IOCM鈥揳nd when it was defined as SCr 鈮?.5 mg/dL it showed a RR 1.48 (CI95%: 0.37鈥?.87)鈥揻avoring LOCM鈥搃n the four studies used this criterion. Mantel-Haenszel stratified test was 蠂2=2.51 (p=0.8).

Conclusion

In patients with renal failure undergoing CT there is a similar risk of CIN with the administration of any contrast media studied. CIN incidence depends on the chosen criteria and is lower with the definition of SCr 鈮?.5 mg/dL at 24鈥?2 h. No agreement was found between CIN definitions were adopted.