title: Statins for the prevention of contrast-induced nephropathy: a systematic review and meta-analysis.
abstract: BACKGROUND
  Retrospective and prospective studies have demonstrated that statins have a protective effect in preventing contrast-induced nephropathy (CIN), but there are currently no established guidelines for statin timing or dosage. A systematic review and meta-analysis was performed to determine whether statin administration is protective and the magnitude of their effect.
  
  
  METHODS
  We searched MEDLINE, EMBASE, Cochrane Library, CNKI and ISI Proceedings for cohort studies comparing the CIN incidence in a chronic statin pretreatment group and a statin-naïve group, as well as for randomized controlled trials (RCTs) comparing short-term high-dose to short-term low-dose statin treatment or placebo. CIN was defined as an increase in serum creatinine >25% or 0.5 mg/dl (44.2 μmol/l). Qualitative analysis of cohort studies and quantitative analysis of RCTs to estimate pooled risk ratios were performed.
  
  
  RESULTS
  Among 6 cohort studies, 4 showed chronic statin pretreatment had a preventive effect against CIN. From 6 RCTs, 1,194 patients were included in the meta-analysis. Under the fixed-effects model, a nonsignificant protective trend toward decreased incidence of CIN with periprocedural short-term high-dose statin treatment was seen (RR: 0.70; 95% CI: 0.48-1.02).
  
  
  CONCLUSIONS
  Current data are not conclusive to whether statins are protective for CIN due to the inherent limitations of the included studies. In the future, large well-designed studies are needed to address the effect of this drug and its longer-term clinical outcomes.
authors: Department of Cardiology, Ren Ji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, PR China.
authors: Tuo
authors: T
authors: Zhang
authors: Ling-Hong
authors: LH
authors: Shen
authors: Liu-Hua
authors: LH
authors: Hu
authors: Ben
authors: B
authors: He
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D007674:Kidney Diseases / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control*; D008875:Middle Aged; D010919:Placebos; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010919:Placebos