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Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled

Jian Xie1, Mingyang Jiang2, Yunni Lin2

  • 11 Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Nanning, Guangxi, China.

Angiology
|January 24, 2019
PubMed

Insights

Alprostadil may help prevent contrast-induced nephropathy (CIN), a common cause of kidney injury. This meta-analysis showed a lower CIN incidence and improved kidney function markers in patients receiving alprostadil.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Contrast-induced nephropathy (CIN) is a significant cause of hospital-acquired acute kidney injury.
  • Alprostadil's role in renal blood flow and electrolyte balance suggests potential for CIN prevention, though evidence is debated.

Purpose of the Study:

  • To evaluate the efficacy of alprostadil in preventing CIN in patients undergoing contrast media procedures.
  • To synthesize existing evidence through a meta-analysis of relevant studies.

Main Methods:

  • A meta-analysis of 36 studies involving 5495 patients was conducted.
  • Patients received standard hydration; the experimental group received alprostadil, while the control group did not.
  • Renal function markers including serum creatinine, BUN, eGFR, cystatin C, CCr, and β2-MG were assessed post-contrast injection.

Main Results:

  • The incidence of CIN was significantly lower in the alprostadil group (6.56%) compared to the control group (16.74%).
  • Patients treated with alprostadil showed reduced levels of SCr, BUN, cystatin C, and β2-MG.
  • Improved CCr and eGFR were observed in the experimental group.

Conclusions:

  • Alprostadil administration appears to reduce the incidence of CIN.
  • The findings suggest alprostadil is a potential therapeutic agent for preventing CIN in patients undergoing coronary angiography and/or PCI.

Keywords:
alprostadilcontrast-induced nephropathymeta-analysis

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