한빛사 논문
건국대학교병원
Myung Hyun Cho,1 Soo Nyung Kim,2,3 Hye Won Park,1,3 Sochung Chung,1,3 and Kyo Sun Kim1,3,*
1 Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea.
2 Department of Obstetrics and Gynecology, Konkuk University Medical Center, Seoul, Korea.
3 Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea.
*Address for Correspondence: Kyo Sun Kim, MD, PhD. Department of Pediatrics, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea.
Abstract
Several clinical studies have proposed a protective role for vitamin E (α-tocopherol) against contrast-induced acute kidney injury (CIAKI). The aim of study was to assess the effects of vitamin E for the prevention of CIAKI. A systematic review and meta-analysis was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) reporting the effects of vitamin E on CIAKI development and measurements of renal function were included. Four trials including 623 participants were analyzed in the meta-analysis. All participants received intravenous hydration in addition to vitamin E or placebo. The incidence of the vitamin E group (5.8%) was lower than that of the control group (15.4%). Compared with the control, vitamin E significantly reduced the risk ratio (RR) of CIAKI by 62% (0.38; 95% confidence interval [CI], 0.22, 0.63; P < 0.010). In addition, vitamin E reduced serum creatinine (SCr) increase after contrast administration (standardized mean difference [SMD], −0.27; 95% CI, −0.49, −0.06; P = 0.010). However, changes in glomerular filtration rate (GFR) after contrast administration were not significantly different between vitamin E and the control group (SMD, 0.21; 95% CI, −0.01, 0.43; P = 0.060). Heterogeneity within the available trials was not observed. Our meta-analysis provides evidence that vitamin E plus hydration significantly reduced the risk of CIAKI in patients with renal impairment compared with hydration alone.
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