Kidney Week

Abstract: TH-PO080

Beneficial Effect of Statin on Preventing Contrast-Induced AKI in Patients with Renal Insufficiency: A Meta-Analysis

Session Information

• AKI: Epidemiology, Risk Factors, Prevention - I
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Cho, Ajin, Hallym university Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)

Ajin Cho,

• Noh, Jung-woo, Chun & Cho's Medical Clinic & Dialysis Center, Seoul, Korea (the Republic of)

Jung-woo Noh,

• Kim, Juhee, Department of Internal Medicine-Nephrology, Gangnam Sacred Heart Hospital, Korea, Republic of, Seoul, Korea (the Republic of)

Juhee Kim,

Background

Renal insufficiency is an important predictor of contrast-induced acute kidney injury (CI-AKI). We performed a meta-analysis to examine the effects of short-term statin therapy on the incidence of CI-AKI, particularly in patients with renal insufficiency.

Methods

A systematic search was conducted to retrieve randomized controlled trials (RCTs) that investigated the impact of statin pretreatment before administration of contrast media on the development of CI-AKI in patients with mild to moderate renal insufficiency. The primary outcome was development of CI-AKI. The secondary outcome was the incidence of AKI requiring hemodialysis.

Results

Data analysis from eight RCTs, which included a total of 2313 subjects in the statin-treated group and 2322 in the control group, showed that statin pretreatment was associated with significant reduction of the risk of CI-AKI (Relative Risk (RR) = 0.59; 95% Confidential Interval (CI) 0.44 to 0.79; p = 0.0003, I² = 0%). A beneficial effect of statin on preventing CI-AKI was consistent, regardless of the dose of statin and use of N-acetylcysteine. The incidence of hemodialysis was low after contrast administration in the statin-treated group, but the reduction was not significant (RR = 0.28; 95% CI 0.05 to 1.70; p = 0.17, I² = 0%). In subgroup analysis based on baseline estimated glomerular filtration rate (eGFR), patients with baseline eGFR < 60 ml/min/1.73 m² (RR = 0.63; 95% CI 0.41 to 0.98; p = 0.04, I² = 0%) and 30 < eGFR < 90 ml/min/1.73 m² (RR = 0.56; 95% CI 0.39 to 0.82; p = 0.003, I² = 0%) showed significant reduction of risk of CI-AKI.

Conclusion

Statin pretreatment is effective at preventing CI-AKI and should be considered in patients with pre-existing renal insufficiency.