Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Table 4

Prospective, randomized clinical trials comparing efficacy of statins and placebo for contrast-induced AKI after angiography prophylaxis.

Authors	Year	Type of procedure and contrast media	Number of patients; Intervention versus control	Study protocol		Intravascular volume expansion and NAC protocol	CI-AKI definition	Mean GFR; Intervention versus control (mL/min/1.73 m^2)	Incidence of CI-AKI		RRT requirement; Intervention versus control (%)
				Intervention	Control				Intervention versus control (%)	𝑃 value
Xinwei et al. [73]	2009	CAG; Iodixanol	115 versus 113	Simvastatin 20 mg/d	Simvastatin 80 mg/d before and 20 mg after	NSS 1 mL/kg/h 6–12 hours before and 12 hours after	↑Cr ≥25%/2 days or; ↑Cr ≥0.5/2 days	86.5 versus 93.6	15.7 versus 5.3	<0.05	ND
Patti et al. [77]	2011	CAG; Iobitridol	120 versus 121	Atorvastatin 80 mg 12 hours and 40 mg 2 hours before	Placebo	NSS 1 mL/kg/h ≥; 12 hours before and 24 hours after	↑Cr ≥25%/1-2 days or; ↑Cr ≥0.5/1-2 days	79.8 versus 77.0	5 versus 13.2	0.046	0 versus 0.8
Quintavalle et al. [78]	2012	CAG; Iodixanol	202 versus 208	Atorvastatin 80 mg 1 days before	None	Isotonic NaHCO3 3 mL/kg/h 1 hour and 1 mL/kg/h 6 hours; NAC 1200 mg po bid	↑CysC ≥10%/1 day; ↑Cr ≥25%/2 days or; ↑Cr ≥0.5/2 days	42 versus 43	4.5 versus 17.8	0.005	ND
Jo et al. [74]	2008	CAG; Iodixanol	124 versus 123	Simvastatin 40 mg po q12h for 2 days	Placebo	N/2 1 mL/kg/h 12 hours before and after	↑Cr ≥25%/2 days or; ↑Cr ≥0.5/2 days	53.46 versus 55.4	2.5 versus 3.4	1.0	0 versus 0.8
Özhan et al. [75]	2010	CAG; ND	Total 130	Atorvastatin	None	NAC	ND	ND	2 patients versus 7 patients*	NS	ND
Toso et al. [76]	2010	CAG; Iodixanol	152 versus 152	Atorvastatin 80 mg/d 2 days before and after	Placebo	NSS 1 mL/kg/h 12 hours before and after; NAC 1200 mg po bid	↑Cr ≥0.5/5 days or; ↑Cr ≥25%/5 days	46 versus 46	9.7 versus 11.2	NS; NS	0 versus 0.7
Han et al. [79]	2013	CAG/PAG; Iodixanol	1498 versus 1500	Rosuvastatin 10 mg/d 2 days before and 3 days after	None	NSS 1 mL/kg/h 12 hours before and 24 hours after	↑Cr ≥25%/3 days or; ↑Cr ≥0.5/3 days	74.16 versus 74.43	2.3 versus 3.9	0.01	0 versus 0.1
Leoncini et al. [80]	2013	CAG; Iodixanol	252 versus 252	Rosuvastatin 40 mg on admission then 20 mg/d	None	NSS 1 mL/kg/h 12 hours before and after; NAC 1200 mg po bid	↑Cr ≥25%/3 days or; ↑Cr ≥0.5/3 days	82.5 versus 82.6	6.7 versus 15.1	0.003	0 versus 0.1

 *The incidences of CI-AKI data in each group are not available. Data is shown as the number of patients who develop CI-AKI.
bid: twice daily; CAG: coronary angiography; CI-AKI: contrast-induced acute kidney injury; Cr: creatinine; CysC: cystatin C; d: day; h: hour; IV: intravenous; kg: kilogram body weight; mg: milligram; mL: milliliter; NAC: N-acetylcysteine; ND: no data; NSS: normal saline solution; N/2: 0.45% NaCl; po: per oral route; PAG: peripheral angiography; q12h: every 12 hours; RRT: renal replacement therapy.