Open AccessProstaglandin E1 administration for prevention of contrast-induced acute kidney injury
Author(s) -
Ning Geng,
Deling Zou,
Yanli Chen,
Li Ren,
Lisheng Xu,
Wenyue Pang,
Yingxian Sun
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000011416
Subject(s) - medicine , confidence interval , odds ratio , acute kidney injury , placebo , creatinine , relative risk , randomized controlled trial , pathology , alternative medicine
Background: PGE1 has been studied for prevention of CI-AKI in several RCTs and significant heterogeneous results exist. Methods: We searched PubMed, EMBase, and Cochrane Central Register of Controlled Trials up to December 26, 2017 for RCTs comparing PGE1 with placebo or other active medications for the prevention of CI-AKI in patients. Odds ratio and 95% confidence interval (CI) were used for pooling dichotomous data, while mean difference and 95% confidence interval for pooling continuous data. Results: Seven RCTs involving 1760 patients were included in this meta-analysis. All these 7 trials reported the incidence of CI-AKI and compared with placebo or other treatment options, PGE1 was associated with a reduced risk of CI-AKI (OR: 0.38, 95% CI: 0.28–0.53; P < .001) and only a trend for lower post procedure serum creatinine (Scr) levels compared with control groups at 48 hours (MD: −0.03 mg/dL, 95% CI: −0.08 to 0.02 mg/dL; P = .25; 6 trials combined). But the postprocedure Scr levels were significantly reduced in PGE1 groups compared with control groups at 72 hours (MD: −0.07 mg/dL, 95% CI: −0.11 to −0.04 mg/dL; P < .001; 4 trials combined). We also meta-analyzed the postprocedure cystatin C (CysC) at 24 and 48 hours with 2 trials. There were lower postprocedure CysC levels in PGE1 groups than those in control groups (MD: −0.18 mg/L, 95% CI: −0.33 to −0.03 mg/L; P = .02 at 24 hours and MD: −0.14 mg/L, 95% CI: −0.23 to −0.06 mg/L; P = .001 at 48 hours). Conclusions: PGE1 provides effective nephroprotection against CI-AKI and may act as a part of effective prophylactic pharmacological regimens.