BioMed Research International / 2014 / Article / Tab 4

Review Article

Nonpharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Table 4

Characteristics of the studies included in the meta-analysis to evaluate the benefit of dialysis versus routine preventive care on the incidence of contrast-induced acute kidney injury.

AuthorsYear publishedStudy designRadiocontrast agentTechniqueTiming Duration of extracorporeal treatment (hour)DialyzerBlood flow
(mL/min)
Dialysate flow
(mL/min)
RR for CI-AKI
(95% CI)

Lehnert et al. [61]1998RCTIopentolHD  min after radiocontrast procedure3Fresenius F50 (Fresenius Medical Care, Bad Homburg, Germany) 5001.33 (95% CI 0.61–2.91)

Sterner et al. [62]2000RCTIohexol, Iodixanol, and IoxaglateHDMaximum 3 hrs after radiocontrast procedure4Low-flux cellulose acetate or diacetate2005001.70 (95% CI 0.59–4.90)

Vogt et al. [63]2001RCTNonionic low osmolarityHDMedian 120 min (range 30–280) after radiocontrast procedure3.1Fresenius F50, F60 (Fresenius Medical Care)1805001.27 (95% CI 0.80–2.01)

Berger et al. [64]2001RCTIopromideHD  min after radiocontrast procedure2-3Fresenius F6 (Fresenius Medical Care)2205003.43 (95% CI 0.45–25.93)

Frank et al. [65]2003RCTIomeprolHDSimultaneously with radiocontrast procedure4Fresenius F60 (Fresenius Medical Care)200500Total clearance of contrast media was significantly increased and the area under curve (AUC) of contrast media concentration was significantly lower in the HD group when compared with control group. However, the authors did not report incidence of CI-AKI.

Gabutti et al. [48]2003Prospective cohortIoversolCVVHDFSimultaneously with radiocontrast procedure10Prisma M100 (Prisma, Hospal, Mirandola, Italy)150Replacement and dialysate 2,000 mL/h1.56 (95% CI 0.66–3.72)

Marenzi et al. [49]2003RCTIopentolCVVHInitiated 4–6 hrs before, interrupted during, and resumed after radiocontrast procedure22–30Renaflow HF700 (Gambro, Mirandola, Italy)100Replacement 1,000 mL/hour; no dialysate0.12 (95% CI 0.05–0.32)

Hsieh et al. [66]2005Retrospective cohortIopromideHDAs soon as technically feasible4AM-Bio HX90 (Asahi Medical Co, Ltd, Tokyo, Japan)2005000.33 (95% CI 0.01–7.72)

Marenzi et al. [67]2006RCTIopentalCVVH6 hours before and for 18 to 24 hours after contrast exposure (pre-/posthemofiltration group) 18 to 24 hours after contrast exposure (posthemofiltration group)18–30Renaflow HF700 (Gambro, Mirandola, Italy)100Replacement 1,000 mL/hour; no dialysate0.05 (95% CI 0.01–0.41) (pre-/posthemofiltration group) 0.52 (95% CI 0.17–1.56) (posthemofiltration group)

Lee et al. [52]2007RCTIohexolHDAs soon as technically feasible (  min, ranging from 45 to 180 min, after exposure to the contrast medium)4High-flux polysulfone membrane (BS1.8, Toray Industries, Inc., Tokyo, Japan).1505000.07 (95% CI 0.01, 0.49)

Reinecke et al. [68]2007RCTIopromideHDWithin 20 min after radiocontrast procedure2Fresenius 8, (Fresenius Medical Care)180500Adjusted OR 2.2 (95% CI 0.9–5.7)

RCT: randomized controlled trial, HD: hemodialysis, CVVH: continuous venovenous hemofiltration, and CVVHDF: continuous venovenous hemodiafiltration.