Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials
Introduction Contrast-induced nephropathy (CIN) is a potential complication associated with the administration of intravenous contrast agents. The objective of this study was to evaluate the effectiveness of remote ischemic preconditioning (RIPC) and two pharmacological interventions in preventing C...
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2431141 |
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| author | Hanchao Gao Weilong Li Chuanchuan Sun Shiping Zhu Fanna Liu Xinhai Zhao Shaodong Luan Shengyun Sun Yeye Yu |
| author_facet | Hanchao Gao Weilong Li Chuanchuan Sun Shiping Zhu Fanna Liu Xinhai Zhao Shaodong Luan Shengyun Sun Yeye Yu |
| author_sort | Hanchao Gao |
| collection | DOAJ |
| description | Introduction Contrast-induced nephropathy (CIN) is a potential complication associated with the administration of intravenous contrast agents. The objective of this study was to evaluate the effectiveness of remote ischemic preconditioning (RIPC) and two pharmacological interventions in preventing CIN.Methods Randomized controlled trials (RCTs) examining the efficacy of RIPC, nicorandil, and trimetazidine in treating CIN were searched within databases such as PubMed, Cochrane Library, Embase, and Web of Science. The primary outcome was the incidence of CIN. The consistency model was used to address heterogeneity and enhance model fit. The assessment of consistency between direct and indirect evidence was conducted through the node-splitting method. Posterior probability estimates and surface under the cumulative ranking area (SUCRA) ranked interventions based on their effectiveness in preventing CIN. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used to grade the quality of evidence.Results Based on hydration therapy, RIPC, nicorandil, and trimetazidine all showed prophylactic effects on CIN compared to control groups. The SUCRA results showed that RIPC (SUCRA = 37.7%, PrBest = 0.4%), nicorandil (SUCRA = 91.2%, PrBest = 74.7%), and trimetazidine (SUCRA = 71.0%, PrBest = 24.9%). However, there were no significant differences between the nicorandil, RIPC, and trimetazidine groups. Subgroup analysis suggested that there was still a protective effect in populations with mean estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 or with a high prevalence of diabetes mellitus.Conclusions Nicorandil, trimetazidine, and RIPC all showed renal protective effects. Based on hydration, nicorandil, trimetazidine, and RIPC may show better prophylaxis against CIN than hydration alone after intravenous contrast administration. |
| format | Article |
| id | doaj-art-e2be7ec3632b439a9a95ed952573307b |
| institution | OA Journals |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-e2be7ec3632b439a9a95ed952573307b2025-08-20T02:29:59ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2431141Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trialsHanchao Gao0Weilong Li1Chuanchuan Sun2Shiping Zhu3Fanna Liu4Xinhai Zhao5Shaodong Luan6Shengyun Sun7Yeye Yu8Department of Nephrology, Shenzhen Longhua District Central Hospital, Shenzhen Longhua District Key Laboratory for Diagnosis and Treatment of Chronic Kidney Disease, Shenzhen, ChinaDepartment of Nephrology, Shenzhen Longhua District Central Hospital, Shenzhen Longhua District Key Laboratory for Diagnosis and Treatment of Chronic Kidney Disease, Shenzhen, ChinaDepartment of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Chinese Traditional Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Chinese Traditional Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Nephrology, Shenzhen Longhua District Central Hospital, Shenzhen Longhua District Key Laboratory for Diagnosis and Treatment of Chronic Kidney Disease, Shenzhen, ChinaDepartment of Chinese Traditional Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaIntroduction Contrast-induced nephropathy (CIN) is a potential complication associated with the administration of intravenous contrast agents. The objective of this study was to evaluate the effectiveness of remote ischemic preconditioning (RIPC) and two pharmacological interventions in preventing CIN.Methods Randomized controlled trials (RCTs) examining the efficacy of RIPC, nicorandil, and trimetazidine in treating CIN were searched within databases such as PubMed, Cochrane Library, Embase, and Web of Science. The primary outcome was the incidence of CIN. The consistency model was used to address heterogeneity and enhance model fit. The assessment of consistency between direct and indirect evidence was conducted through the node-splitting method. Posterior probability estimates and surface under the cumulative ranking area (SUCRA) ranked interventions based on their effectiveness in preventing CIN. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used to grade the quality of evidence.Results Based on hydration therapy, RIPC, nicorandil, and trimetazidine all showed prophylactic effects on CIN compared to control groups. The SUCRA results showed that RIPC (SUCRA = 37.7%, PrBest = 0.4%), nicorandil (SUCRA = 91.2%, PrBest = 74.7%), and trimetazidine (SUCRA = 71.0%, PrBest = 24.9%). However, there were no significant differences between the nicorandil, RIPC, and trimetazidine groups. Subgroup analysis suggested that there was still a protective effect in populations with mean estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 or with a high prevalence of diabetes mellitus.Conclusions Nicorandil, trimetazidine, and RIPC all showed renal protective effects. Based on hydration, nicorandil, trimetazidine, and RIPC may show better prophylaxis against CIN than hydration alone after intravenous contrast administration.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2431141Contrast-induced nephropathyremote ischemic preconditioningnicorandiltrimetazidinenetwork meta-analysis |
| spellingShingle | Hanchao Gao Weilong Li Chuanchuan Sun Shiping Zhu Fanna Liu Xinhai Zhao Shaodong Luan Shengyun Sun Yeye Yu Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials Renal Failure Contrast-induced nephropathy remote ischemic preconditioning nicorandil trimetazidine network meta-analysis |
| title | Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials |
| title_full | Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials |
| title_fullStr | Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials |
| title_full_unstemmed | Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials |
| title_short | Effect of remote ischemic preconditioning, nicorandil, and trimetazidine in contrast-induced nephropathy: a network meta-analysis of randomized controlled trials |
| title_sort | effect of remote ischemic preconditioning nicorandil and trimetazidine in contrast induced nephropathy a network meta analysis of randomized controlled trials |
| topic | Contrast-induced nephropathy remote ischemic preconditioning nicorandil trimetazidine network meta-analysis |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2431141 |
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