Does Ascorbic Acid Protect Against Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:62

Article

Sadat, Umar¹  Usman, Ammara²  Gillard, Jonathan H.³  Boyle, Jonathan R.¹ 

[1] Cambridge Univ Hosp NHS Fdn Trust, Dept Surg, Cambridge, England

[2] Cavalry Hosp, Cardiovasc Med Div, Dept Internal Med, Lahore, Pakistan

[3] Univ Cambridge, Univ Dept Radiol, Cambridge, England

关键词: acute kidney injury;    angiography;    ascorbic acid;    contrast-induced nephropathy;   

DOI  :  10.1016/j.jacc.2013.07.065

来源: Elsevier

【 摘 要 】

Objectives This study sought to perform a systematic review with meta-analysis of randomized controlled trials comparing the use of ascorbic acid with placebo or other treatment options for the treatment of contrast induced-acute kidney injury (CI-AKI) in patients undergoing coronary angiography. Background CI-AKI remains the most widely discussed and debated topic in cardiovascular medicine, with its incidence increasing due to an increasing number of contrast media-enhanced radiological procedures being performed. Methods MEDLINE, Embase, and Cochrane central databases were searched from inception to May 2013, without language restrictions. For a study to be selected, it had to report the incidence of CI-AKI as an outcome measure. Studies were excluded if at least 1 study arm did not have ascorbic acid administered alone or with saline solution hydration. Data were extracted by 1 author, and random checks were made by another author. Results Nine randomized, controlled trials reported data on the incidence of CI-AKI in 1,536 patients who had completed the trial and were included in the final analysis. Patients receiving ascorbic acid had 33% less risk of CI-AKI compared with patients receiving placebo or an alternate pharmacological treatment (risk ratio by random-effects model: 0.672; 95% confidence interval, 0.466 to 0.969; p = 0.034). Conclusions Ascorbic acid provides effective nephroprotection against CI-AKI and may form a part of effective prophylactic pharmacological regimens. (C) 2013 by the American College of Cardiology Foundation

【 授权许可】

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