The relative renal safety of iso-osmolar contrast media compared with low-osmolar contrast media in intravenous contrast-enhanced CT: a Meta-analysis / 中华肾脏病杂志

ABSTRACT

Objective To compare the nephrotoxicity of the iso-osmolar contrast media (iodixanol) to low-osmolar contrast media (LOCM) in intravenous contrast-enhanced CT.Methods Randomized controlled trials (RCTs) of iodixanol or low-osmolar contrast media in intravenous contrastenhanced CT were searched in the database of VIP,CBM,CNKI,Wanfang,PubMed,EMBASE,Web of Science,Cochrane Library from their start year to July 2012.Screening and information extracted were did by two researchers independently.The quality of the included documents was evaluated by the criterion of Cochrane handbook.Revman software (version 5.0) of the Cochrane collaboration was used in data analysis.Results There was no significant difference in the incidence of contrast-induced nephropathy (CIN) among 6 trials recruited 907 patients between the iodixanol group and the LOCM group [RR =0.64,95％CI (0.31-1.32),P=0.22] by using serum creatinine increased by more than 44 μmol/L (0.5 mg/dl) as the diagnostic criteria.No considerable difference was existed by using serum creatinine increased by more than 25％ as the diagnostic criteria between the two groups [RR =0.79,95％CI (0.48-1.30),P =0.35].Subgroup analysis showed there was no obvious difference [RR =0.57,95％CI (0.30-1.10),P =0.09] between the two groups in patients with increased baseline of serum creatinine.No obvious difference were gained in normal baseline group [RR =1.28,95％CI (0.57-2.86),P =0.55].Conclusion Compared with low-osmolar contrast media,iodixanol is not associated with less CIN in intravenous contrast-enhanced CT.