Predictive Value of Hepatorenal Status in Contrast-Induced Nephropathy Among Patients Receiving Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis
Restricted accessResearch articleFirst published online August, 2019
Predictive Value of Hepatorenal Status in Contrast-Induced Nephropathy Among Patients Receiving Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis
Low serum albumin, high blood urea nitrogen (BUN), and uric acid are regarded closely related to the incidence of contrast-induced nephropathy (CIN), whereas it remains unclear whether they can function as predictors of CIN onset. The objective of this systematic review and meta-analysis was to explore the association between abovementioned indicators and CIN incidence rate in patients receiving coronary angiography (CAG) and/or intervention.
Methods:
Clinical studies were retrieved from the electronic databases of PubMed, EMBASE, Google Scholar, Clinical Trials, and ScienceDirect from their inception to July 13, 2018. Meta-analysis was performed on pooled eligible studies to determine whether these hepatorenal indicators were associated with CIN.
Results:
A total of 18 studies involving 16 171 patients were included in the meta-analysis. Pooled analysis results revealed that patients with hypoalbuminemia (odds ratio [OR] = 3.09, 95% confidence interval [CI] = 1.44-6.64, P = .004) and hyperuricemia (OR = 1.32, 95% CI = 1.15-1.50, P < .0001) both exhibited significantly higher CIN rates, regardless of the study design, renal function, and whether urgent clinical situation or not. However, there was no significant association between serum BUN and CIN risk.
Conclusion:
Hypoalbuminemia and hyperuricemia are independently associated with the occurrence of CIN among the patients undergoing CAG and/or intervention.
WatabeHSatoAHoshiT. Association of contrast-induced acute kidney injury with long-term cardiovascular events in acute coronary syndrome patients with chronic kidney disease undergoing emergent percutaneous coronary intervention. Int J Cardiol. 2014;174(1):57–63.
2.
LiuYChenJYTanN. Safe limits of contrast vary with hydration volume for prevention of contrast-induced nephropathy after coronary angiography among patients with a relatively low risk of contrast-induced nephropathy. Circ Cardiovasc Interv. 2015;8(6).
3.
LeonciniMTosoAMaioliMTropeanoFVillaniSBellandiF. Early high-dose rosuvastatin for contrast-induced nephropathy prevention in acute coronary syndrome: results from the PRATO-ACS Study (Protective effect of rosuvastatin and antiplatelet therapy on contrast-induced acute kidney injury and myocardial damage in patients with acute coronary syndrome). J Am Coll Cardiol. 2014;63(1):71–9.
4.
WadaHDohiTMiyauchiK. Long-term clinical impact of serum albumin in coronary artery disease patients with preserved renal function. Nutr Metab Cardiovasc Dis. 2018;28(3):285–290.
5.
WadaHDohiTMiyauchiK. Impact of serum albumin levels on long-term outcomes in patients undergoing percutaneous coronary intervention. Heart Vessels. 2017;32(9):1085–1092.
6.
WadaHDohiTMiyauchiK. Independent and combined effects of serum albumin and C-reactive protein on long-term outcomes of patients undergoing percutaneous coronary intervention. Circ J. 2017;81(9):1293–1300.
7.
YamamotoESatoYSawaTFujiwaraTFujiwaraHTakatsuY. Correlation between serum concentrations of B-type natriuretic peptide and albumin in patients with chronic congestive heart failure. Int Heart J. 2012;53(4):234–7.
8.
CauthenCALipinskiMJAbbateA. Relation of blood urea nitrogen to long-term mortality in patients with heart failure. Am J Cardiol. 2008;101(11):1643–7.
9.
YuJHanJMaoJGuoLGaoW. Association between serum uric acid level and the severity of coronary artery disease in patients with obstructive coronary artery disease. Chin Med J (Engl). 2014;127(6):1039–45.
10.
LazzeroniDBiniMCamaioraU. Serum uric acid level predicts adverse outcomes after myocardial revascularization or cardiac valve surgery. Eur J Prev Cardiol. 2018;25(2):119–26.
11.
GuJFanYQZhangHLZhangJFWangCQ. Serum uric acid is associated with incidence of heart failure with preserved ejection fraction and cardiovascular events in patients with arterial hypertension. J Clin Hypertens (Greenwich). 2018;20(3):560–7.
12.
ItoSNaritomiHOgiharaT. Impact of serum uric acid on renal function and cardiovascular events in hypertensive patients treated with losartan. Hypertens Res. 2012;35(8):867–73.
13.
Mora-RamirezMEstevez-GarciaIOIrigoyen-CamachoMEBojalilRGonzalez-PachecoHAmezcua-GuerraLM. Hyperuricemia on admission predicts short-term mortality due to myocardial infarction in a population with high prevalence of cardiovascular risk factors. Rev Invest Clin. 2017;69(5):247–53.
14.
MagnoniMBerteottiMCeriottiF. Serum uric acid on admission predicts in-hospital mortality in patients with acute coronary syndrome. Int J Cardiol. 2017;240:25–9.
15.
StroupDFBerlinJAMortonSC. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.
16.
MoherDLiberatiATetzlaffJAltmanDG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–41.
17.
CotaGFde SousaMRFereguettiTORabelloA. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison. PLoS Negl Trop Dis. 2013;7(5):e2195.
18.
KimSJChoiDKoYG. Relation of homocysteinemia to contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Am J Cardiol. 2011;108(8):1086–91.
19.
KooHMDohFMKoKI. Diastolic dysfunction is associated with an increased risk of contrast-induced nephropathy: a retrospective cohort study. BMC Nephrol. 2013;14:146.
20.
MuratSNKurtulAYarliogluesM. Impact of serum albumin levels on contrast-induced acute kidney injury in patients with acute coronary syndromes treated with percutaneous coronary intervention. Angiology. 2015;66(8):732–7.
21.
LiuYHLiuYChenJY. LDL cholesterol as a novel risk factor for contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. Atherosclerosis. 2014;237(2):453–9.
22.
ToprakOCiritMEsiEPostaciNYesilMBayataS. Hyperuricemia as a risk factor for contrast-induced nephropathy in patients with chronic kidney disease. Catheter Cardiovasc Interv. 2006;67(2):227–35.
23.
LiebetrauCGaedeLDoerrO. Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of contrast-induced nephropathy after percutaneous coronary intervention. Scand J Clin Lab Invest. 2014;74(2):81–8.
24.
LinKYZhengWPBeiWJ. A novel risk score model for prediction of contrast-induced nephropathy after emergent percutaneous coronary intervention. Int J Cardiol. 2017;230:402–412.
25.
SahinIKarabulutAAvciII. Contribution of platelets indices in the development of contrast-induced nephropathy. Blood Coagul Fibrinolysis. 2015;26(3):246–9.
26.
ElbasanZŞahinDYGürM. Contrast-induced nephropathy in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Angiology. 2014;65(1):37–42.
27.
KurtulAYarliogluesMDuranM. Predictive value of CHA2DS2-VASC score for contrast-induced nephropathy after percutaneous coronary intervention for acute coronary syndrome. Am J Cardiol. 2017;119(6):819–25.
28.
LiYLiuYShiDYangLLiangJZhouY. Insulin resistance increases the risk of contrast-induced nephropathy in patients undergoing elective coronary intervention. Angiology. 2016;67(2):139–45.
29.
MendiMAAfsarBOksuzF. Uric acid is a useful tool to predict contrast-induced nephropathy. Angiology. 2017;68(7):627–32.
30.
SaritemurMTurkeliMKalkanKTanbogaİHAksakalE. Relation of uric acid and contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention in the ED. Am J Emerg Med. 2014;32(2):119–23.
31.
BarbieriLVerdoiaMSchafferA. Uric acid levels and the risk of contrast induced nephropathy in patients undergoing coronary angiography or PCI. Nutr Metab Cardiovasc Dis. 2015;25(2):181–6.
32.
GuoWLiuYChenJY. Hyperuricemia is an independent predictor of contrast-induced acute kidney injury and mortality in patients undergoing percutaneous coronary intervention. Angiology. 2015;66(8):721–6.
33.
KowalczykJFrancuzPSwobodaR. Prognostic significance of hyperuricemia in patients with different types of renal dysfunction and acute myocardial infarction treated with percutaneous coronary intervention. Nephron Clin Pract. 2010;116(2):c114–22.
34.
OkinoSFukuzawaSInagakiM. Hyperuricemia as a risk factor for progressive renal insufficiency after coronary intervention in patients with chronic kidney disease. Cardiovasc Interv Ther. 2010;25(2):105–11.
35.
ToprakOCiritMYesilM. Impact of diabetic and pre-diabetic state on development of contrast-induced nephropathy in patients with chronic kidney disease. Nephrol Dial Transplant. 2007;22(3):819–26.
36.
KurtulAOcekAHMuratSN. Serum albumin levels on admission are associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Angiology. 2015;66(3):278–85.
37.
OduncuVErkolAKarabayCY. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013;24(2):88–94.
38.
HinsonJSEhmannMRFineDM. Risk of acute kidney injury after intravenous contrast media administration. Ann Emerg Med. 2017;69(5):577–586.e4.
39.
SangBHBangJYSongJGHwangGS. Hypoalbuminemia within two postoperative days is an independent risk factor for acute kidney injury following living donor liver transplantation: a propensity score analysis of 998 consecutive patients. Crit Care Med. 2015;43(12):2552–61.
40.
RodriguezESolerMJRapO. Risk factors for acute kidney injury in severe rhabdomyolysis. PLoS One. 2013;8(12):e82992.
41.
LeeEHBaekSHChinJH. Preoperative hypoalbuminemia is a major risk factor for acute kidney injury following off-pump coronary artery bypass surgery. Intensive Care Med. 2012;38(9):1478–86.
42.
BorekciAGürMTürkoğluC. Oxidative stress and paraoxonase 1 activity predict contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology. 2015;66(4):339–45.
43.
ZhangWJFreiB. Albumin selectively inhibits TNF alpha-induced expression of vascular cell adhesion molecule-1 in human aortic endothelial cells. Cardiovasc Res. 2002;55(4):820–9.
44.
NoughHEghbalFSoltaniM. Incidence and main determinants of contrast-induced nephropathy following coronary angiography or subsequent balloon angioplasty. Cardiorenal Med. 2013;3(2):128–35.
45.
TakirMKostekOOzkokA. Lowering uric acid with allopurinol improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia. J Investig Med. 2015;63(8):924–9.
46.
KanbayMJensenTSolakY. Uric acid in metabolic syndrome: From an innocent bystander to a central player. Eur J Intern Med. 2016;29:3–8.
47.
EjazAAAlquadanKFDassBShimadaMKanbayMJohnsonRJ. Effects of serum uric acid on estimated GFR in cardiac surgery patients: a pilot study. Am J Nephrol. 2015;42(6):402–9.
48.
ChenLLiXLQiaoW. Serum uric acid in patients with acute ST-elevation myocardial infarction. World J Emerg Med. 2012;3(1):35–9.
49.
MiljkovikLVSpiroskaV. Heart failure with preserved ejection fraction - concept, pathophysiology, diagnosis and challenges for treatment. Open Access Maced J Med Sci. 2015;3(3):521–7.
50.
ErolTTekinAKatırcıbaşıMT. Efficacy of allopurinol pretreatment for prevention of contrast-induced nephropathy: a randomized controlled trial. Int J Cardiol. 2013;167(4):1396–9.
51.
ZuoTJiangLMaoSLiuXYinXGuoL. Hyperuricemia and contrast-induced acute kidney injury: a systematic review and meta-analysis. Int J Cardiol. 2016;224:286–94.
