Efficacy of alprostadil for preventing of contrast-induced nephropathy: A meta-analysis
Jing-Zhan Zhang1, Xiao-Jing Kang1, Ying Gao2
1Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, P.R. China.
Insights
Alprostadil significantly reduces the risk of contrast-induced nephropathy (CIN), a common hospital-acquired kidney injury. This meta-analysis confirms its protective effect, lowering CIN incidence and improving kidney function markers.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Medicine
Background:
- Contrast-induced nephropathy (CIN) is a major cause of hospital-acquired acute kidney injury.
- The preventative role of alprostadil in CIN remains debated, necessitating further investigation.
Purpose of the Study:
- To evaluate the efficacy of alprostadil in preventing contrast-induced nephropathy through a comprehensive meta-analysis.
Main Methods:
- Systematic search of multiple databases (PubMed, Web of Science, etc.) for relevant clinical trials.
- Inclusion of 19 clinical trials with 2267 participants.
- Meta-analysis using random or fixed effect models to calculate pooled odds ratios (ORs) and standardized mean differences (SMDs).
Main Results:
- Alprostadil significantly decreased the overall risk of CIN (OR = 0.29, P < 0.00001).
- A significant reduction in CIN risk was also observed in the subgroup of patients undergoing coronary angiography (OR = 0.27, P < 0.00001).
- Alprostadil use was associated with reduced postcontrast serum creatinine (Scr), blood urea nitrogen (BUN), and cystatin C (CysC) levels.
Conclusions:
- Alprostadil demonstrates a significant preventative effect against contrast-induced nephropathy.
- The drug may help reduce kidney damage markers and the incidence of CIN, particularly in high-risk procedures like coronary angiography.
Abstract:
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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