scholarly journals The Effect of Renin-Angiotensin-Aldosterone System Blockade Medications on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0129747 ◽  
Author(s):  
Zhijun Wu ◽  
Huan Zhang ◽  
Wei Jin ◽  
Yan Liu ◽  
Lin Lu ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Meta Analysis ◽  
Contrast Induced Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin

scholarly journals Meta-analysis of effect of renin–angiotensin–aldosterone system blockers on contrast-induced nephropathy

2020 ◽  
Vol 21 (2) ◽  
pp. 147032032091958
Author(s):  
Weidong Wang ◽  
Wei Qu ◽  
Dan Sun ◽  
Xiaodan Liu
Keyword(s):  
Older People ◽  
Sample Size ◽  
Meta Analysis ◽  
Control Group ◽  
Inclusion Criteria ◽  
Contrast Induced Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Increased Risk ◽  
Larger Sample

Background: The purpose of this study was to systematically evaluate the effect of renin–angiotensin–aldosterone system blockers on the incidence of contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention. Methods: A systematic literature search of several databases was conducted to identify studies that met the inclusion criteria. A total of 12 studies with 14 trials that performed studies on a total of 4864 patients (2484 treated with renin–angiotensin–aldosterone system blockers and 2380 in the control group) were included. The primary endpoint was the overall incidence of contrast-induced nephropathy. Analyses were performed with STATA version 12.0. Results: The overall contrast-induced nephropathy incidence in renin–angiotensin–aldosterone system blocker and control groups was 10.43% and 6.81%, respectively. The pooled relative risk of contrast-induced nephropathy incidence was 1.22 (95% confidence interval: 0.81–1.84) in the renin–angiotensin–aldosterone system blocker group. An increased risk of developing contrast-induced nephropathy in the renin–angiotensin–aldosterone system blocker group was observed among older people, non-Asians, chronic users, and studies with larger sample size, and the pooled RRs and 95% confidence intervals were 2.02 (1.21–3.36), 2.30 (1.41–3.76), 1.69 (1.10–2.59) and 1.83 (1.28–2.63), respectively. Conclusions: Intervention with renin–angiotensin–aldosterone system blockers was associated with an increased risk of contrast-induced nephropathy among non-Asians, chronic users, older people, and studies with larger sample size. Large clinical trials with strict inclusion criteria are needed to confirm our results and to evaluate the effect further.

MO421THE EFFECT OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM BLOCKADE MEDICATIONS ON CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Emna Chaabouni ◽  
Hela Jbali ◽  
Najjar Mariem ◽  
Mzoughi Khadija ◽  
Zouaghi Mohamed karim
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Coronary Angiography ◽  
Low Cost ◽  
Contrast Induced Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade ◽  
Significant Difference ◽  
The Impact

Abstract Background and Aims Contrast-induced nephropathy (CIN) is the main complication of contrast media administration in patients undergoing coronary angiography (CAG). This complication may be accelerated by concurrent renin-angiotensin-aldosterone system (RAAS) blockers . Current literature is inconclusive. We investigated the impact of RAAS blockade on the occurrence of CIN in patients undergoing CAG. Method We prospectively enrolled 158 patients who underwent CAG with or without percutaneous coronary intervention from December 2017 to February 2018 at a cardiology department . CIN was defined as an increase in serum creatinine level >25% or 0.5 mg/dL after 48 hours postcardiac catheterization. Results Of 158 patients (females=36.1%, mean age 60.0 ± 11 years) who underwent CAG , 15 (9,5%) developed CIN . Eighty one patients (51,2%) were chronic RAAS blockade users. There was no significant difference between the two groups, RAAS blockade 'used' versus 'not-used', in the incidence of postprocedural CIN (7,5% vs 11,5%, p=0,38). However , the pre-contrast use of RASS blockers decrease the risk of CIN in patients with chronic renal failure (12,5% vs 66,6% , p=0,042) . Conclusion RAAS blockade isn’t associated with a significantly higher incidence of CIN, whereas it has the potential to mitigate the incidence of CIN in patients with chronic renal failure. This low cost intervention could be considered when referring a patient for cardiac catheterization.

The Impact of Renin-Angiotensin-Aldosterone System Blockade on Contrast-Induced Nephropathy: A Meta-Analysis of 12 Studies with 4,493 Patients

Cardiology ◽  
2014 ◽  
Vol 130 (1) ◽  
pp. 4-14 ◽  
Author(s):  
Sang-Ho Jo ◽  
Joo Myung Lee ◽  
Jonghanne Park ◽  
Hyo-Soo Kim
Keyword(s):  
Meta Analysis ◽  
Preventive Measure ◽  
Pooled Analysis ◽  
Contrast Induced Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade ◽  
Significant Difference ◽  
Stratified Analysis ◽  
The Impact

Objectives: This meta-analysis investigated the impact of renin-angiotensin-aldosterone system (RAAS) blockade on the occurrence of contrast-induced nephropathy (CIN). Methods: Twelve studies comparing the use of RAAS blockade in a total of 4,493 patients undergoing a contrast-using procedure were included. The primary endpoint was the overall postprocedural incidence of CIN. Results: In the overall pooled analysis, there was no significant difference between the two groups, RAAS blockade ‘used' versus ‘not-used', in the incidence of postprocedural CIN in the random-effects model (OR 1.27, 95% CI 1.77-2.11, p = 0.351, I2 = 61.9%). In the stratified analysis, however, for chronic RAAS blockade users, the continuation of the drug was significantly associated with a higher incidence of CIN compared with discontinuation (OR 2.06, 95% CI 1.62-2.61, p < 0.001, I2 = 0.0%). A hazard of continuation was marked in a subgroup of older patients or in patients with chronic kidney disease. For drug-na9ve patients, however, administration of RAAS blockade before contrast procedures did not reduce the development of CIN significantly (OR 0.52, 95% CI 0.23-1.16, p = 0.108, I2 = 34.2%). Conclusion: Discontinuation of RAAS blockade in chronic users is associated with a significantly lower incidence of CIN, whereas administration of RAAS blockade as a preventive measure for na9ve patients did not show a significant effect on the incidence of CIN. i 2014 S. Karger AG, Basel

scholarly journals META-ANALYSIS OF SAFETY AND EFFICACY OF RENIN ANGIOTENSIN ALDOSTERONE SYSTEM INHIBITORS IN COVID-19 POPULATION

2021 ◽  
Vol 77 (18) ◽  
pp. 3158
Author(s):  
Yasar Sattar ◽  
Pradeeksha Mukuntharaj ◽  
Hassan Attique ◽  
Waqas Ullah ◽  
Muhammad Khawar Sana ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Renin Angiotensin Aldosterone System ◽  
Safety And Efficacy ◽  
Renin Angiotensin

Strategies Preventing Contrast-Induced Nephropathy After Coronary Angiography: A Comprehensive Meta-Analysis and Systematic Review of 125 Randomized Controlled Trials

Angiology ◽  
2016 ◽  
Vol 68 (5) ◽  
pp. 389-413 ◽  
Author(s):  
Sadegh Ali-Hassan-Sayegh ◽  
Seyed Jalil Mirhosseini ◽  
Zahra Ghodratipour ◽  
Zahra Sarrafan-Chaharsoughi ◽  
Elham Rahimizadeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coronary Angiography ◽  
Vitamin C ◽  
Enzyme Inhibitors ◽  
Meta Analysis ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Pooled Analysis ◽  
Loop Diuretics ◽  
Contrast Induced Nephropathy ◽  
Converting Enzyme Inhibitors

This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations ( N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics, and angiotensin-converting enzyme inhibitors [ACEIs]) on the incidence of contrast-induced nephropathy (CIN) and requirement for hemodialysis after coronary angiography. After screening, a total of 125 trials that reported outcomes were identified. Pooled analysis indicated beneficial effects of SB versus NS (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.56-0.94; P = .01), NAC (OR = 0.79; 95% CI: 0.70-0.88; P = .001), vitamin C (OR = 0.64; 95% CI: 0.45-0.89; P = .01), statins (OR = 0.45; 95% CI: 0.35-0.57; P = .001), AA (OR = 0.28; 95% CI: 0.14-0.47; P = .001), loop diuretics (OR = 0.97; 95% CI: 0.33-2.85; P = .9), and ACEI (OR = 1.06; 95% CI: 0.69-1.61; P = .8). Overall, hydration with SB, use of supplements, such as NAC and vitamin C, and administration of statins and AA should always be considered for the prevention of CIN after coronary angiography.

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