Abstract 11924: Iso-osmolar Contrast Media Superior in Chronic Kidney Disease Patients Undergoing Coronary Angiography: A Meta Analysis of Current Evidence
Background: Coronary angiography is one of the most common causes of contrast-induced nephropathy. Adequate hydration and keeping the volume of contrast media to a minimum are class 1b recommendations for preventing contrast-induced nephropathy. Current data are insufficient to justify specific recommendations about iso- and low-osmolar contrast media, and no specific guidelines on use of different contrast media have been provided by ACCF/AHA/SCAI.
Objective: We performed a systematic review and meta-analysis comparing the renal safety of iso-osmolar to low-osmolar contrast media in chronic kidney disease patients with stage 3 and above who underwent coronary angiography.
Methods: Randomized trials comparing iso- to low-osmolar contrast media in chronic kidney disease stage 3 and above patients undergoing coronary angiography, and reporting contrast-induced nephropathy by a rise in creatinine of 25% from baseline were included in the analysis. Meta-analysis was done using a fixed effects size model and results were expressed in terms of Odds Ratio (OR) and 95% Confidence Interval (CI) after evaluating for interstudy heterogeneity using I2.
Results: A total of 2,007 patients were included in 7 trials, in which 1,019 patients received iso-osmolar and 988 received low-osmolar contrast media. When compared to low-osmolar contrast media, use of iso-osmolar contrast media showed statistical significant benefit in terms of preventing contrast-induced nephropathy in chronic kidney disease patients (OR=0.75, [CI: 0.58, 0.96], p=0.02, I2 =64%).
Conclusion: In chronic kidney disease patients with stage 3 and above undergoing coronary angiography, use of iso-osmolar contrast media showed benefit in terms of preventing contrast-induced nephropathy compared to low-osmolar contrast media.
Author Disclosures: B.P. Pandya: None. S. Gaddam: None. S. Pandya: None. S. El-Sayegh: None. R. Kandov: None. J. Lafferty: None.
- © 2015 by American Heart Association, Inc.