Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis
Aims. Many previous studies have examined the effect of different hydration strategies on prevention of contrast-induced acute kidney injury (CI-AKI), but the optimal strategy is unknown. We performed a network meta-analysis (NWM) of these previous studies to identify the optimal strategy. Methods a...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/7292675 |
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| author | Qiuping Cai Ran Jing Wanfen Zhang Yushang Tang Xiaoping Li Tongqiang Liu |
| author_facet | Qiuping Cai Ran Jing Wanfen Zhang Yushang Tang Xiaoping Li Tongqiang Liu |
| author_sort | Qiuping Cai |
| collection | DOAJ |
| description | Aims. Many previous studies have examined the effect of different hydration strategies on prevention of contrast-induced acute kidney injury (CI-AKI), but the optimal strategy is unknown. We performed a network meta-analysis (NWM) of these previous studies to identify the optimal strategy. Methods and Results. Web of Science, PubMed, OVID Medline, and Cochrane Library were searched from their inception dates to September 30, 2018. Randomized controlled trials (RCTs) were selected based on strict inclusion criteria, and a Bayesian NWM was performed using WinBUGS V.1.4.3. We finally analyzed 60 eligible RCTs, which examined 21,293 patients and 2232 CI-AKI events. Compared to intravenous 0.9% sodium chloride (reference), intravenous sodium bicarbonate (OR [95% CI]: 0.74 [0.57, 0.93]), hemodynamic guided hydration (0.41 [0.18, 0.93]), and RenalGuard guided hydration (0.32 [0.14, 0.70]) significantly reduced the occurrence of CI-AKI. Oral hydration and intravenous 0.9% sodium chloride were each noninferior to no hydration in preventing CI-AKI. Intravenous 0.9% sodium chloride, sodium bicarbonate, and hemodynamic guided hydration were each noninferior to oral hydration in preventing CI-AKI. Based on surface under the cumulative ranking curve values, the RenalGuard system was best (0.974) and hemodynamic guided hydration was second best (0.849). Conclusion. There was substantial evidence to support the use of RenalGuard or hemodynamic guided hydration for preventing CI-AKI in high-risk patients, especially those with chronic kidney disease or cardiac dysfunction. |
| format | Article |
| id | doaj-art-57ac1ff31b534bd081428b4bfb6ee819 |
| institution | OA Journals |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-57ac1ff31b534bd081428b4bfb6ee8192025-08-20T02:05:49ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/72926757292675Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-AnalysisQiuping Cai0Ran Jing1Wanfen Zhang2Yushang Tang3Xiaoping Li4Tongqiang Liu5Division of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, ChinaDivision of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, ChinaDivision of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, ChinaDivision of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, ChinaDivision of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, ChinaDivision of Nephrology, The Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, ChinaAims. Many previous studies have examined the effect of different hydration strategies on prevention of contrast-induced acute kidney injury (CI-AKI), but the optimal strategy is unknown. We performed a network meta-analysis (NWM) of these previous studies to identify the optimal strategy. Methods and Results. Web of Science, PubMed, OVID Medline, and Cochrane Library were searched from their inception dates to September 30, 2018. Randomized controlled trials (RCTs) were selected based on strict inclusion criteria, and a Bayesian NWM was performed using WinBUGS V.1.4.3. We finally analyzed 60 eligible RCTs, which examined 21,293 patients and 2232 CI-AKI events. Compared to intravenous 0.9% sodium chloride (reference), intravenous sodium bicarbonate (OR [95% CI]: 0.74 [0.57, 0.93]), hemodynamic guided hydration (0.41 [0.18, 0.93]), and RenalGuard guided hydration (0.32 [0.14, 0.70]) significantly reduced the occurrence of CI-AKI. Oral hydration and intravenous 0.9% sodium chloride were each noninferior to no hydration in preventing CI-AKI. Intravenous 0.9% sodium chloride, sodium bicarbonate, and hemodynamic guided hydration were each noninferior to oral hydration in preventing CI-AKI. Based on surface under the cumulative ranking curve values, the RenalGuard system was best (0.974) and hemodynamic guided hydration was second best (0.849). Conclusion. There was substantial evidence to support the use of RenalGuard or hemodynamic guided hydration for preventing CI-AKI in high-risk patients, especially those with chronic kidney disease or cardiac dysfunction.http://dx.doi.org/10.1155/2020/7292675 |
| spellingShingle | Qiuping Cai Ran Jing Wanfen Zhang Yushang Tang Xiaoping Li Tongqiang Liu Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis Journal of Interventional Cardiology |
| title | Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis |
| title_full | Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis |
| title_fullStr | Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis |
| title_full_unstemmed | Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis |
| title_short | Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis |
| title_sort | hydration strategies for preventing contrast induced acute kidney injury a systematic review and bayesian network meta analysis |
| url | http://dx.doi.org/10.1155/2020/7292675 |
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