Contrast-induced nephropathy (CIN) is a type of acute kidney injury associated with intravascular
administration of iodinated contrast, usually reversible. Contrast agents are an essential component of invasive
and noninvasive coronary angiography. These agents have been modified over time to enhance patient safety and
tolerability, but adverse reactions still occur. CIN has been variably defined, as a rise in serum creatinine of 0.5
mg/dl, or a 25% increase in serum creatinine above baseline within 24-72 hours after the procedure. The incidence
of CIN varies based on the definition used and risk profile of the patients. CIN is rare among patients with
normal renal function at baseline. In low-risk patients, CIN occurs in 1-5%, whereas in higher-risk populations,
the incidence can be as high as 30%. CIN is also associated with a 5- to 20-fold increased risk of other early
adverse events including in-hospital myocardial infarction, target vessel occlusion, and early mortality. The main
prevention strategies are adequate intravenous hydration before, during and after the procedure as well as restriction
of contrast load with maximum volume approximately no more than three times the serum creatinine clearance.
Recent observational and small prospective randomized trials demonstrate the reduction of CIN incidence
with HMG-CoA enzyme inhibitors. In this systematic review and meta-analysis we explore the effects of statin
administration in prevention of CIN.
Keywords: Statins, contrast induced nephropathy, meta-analysis, kidney, coronary angiography, intravenous hydration.
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