title: Short-term, high-dose statins in the prevention of contrast-induced nephropathy: a systematic review and meta-analysis.
abstract: BACKGROUND
  There have been conflicting reports on the use of statins for prevention of contrast-induced nephropathy (CIN). The aim of this study was to assess the effectiveness of short-term (2 - 7 days), high-dose (80 mg/d) statins in the prevention of CIN. STUDY DESIGN, SETTING AND PARTICIPANTS: Randomized controlled trials assessing the preventive effect of short-term, highdose statins on CIN (published from 1966 to 2010) were searched.
  
  
  METHODS
  Quality of the trials was evaluated with the assessing risk of bias in studies included in the Cochrane reviews.
  
  
  RESULTS
  CIN is the primary endpoint of the study.
  
  
  METHODS
  Meta-regression and a fixed-effects model were used for analyses.
  
  
  RESULTS
  Five trials with a total of 1,009 patients were identified, with the overall effect of statins showing benefit for preventing CIN (relative risk (RR) = 0.53, 0.32 - 0.87). Meta-regression showed the existence of minor heterogeneity (I² = 19%) could be largely accounted for by baseline serum creatinine. Two studies conducted in patients with CKD Stage ≥ 3 did not reveal a statistically significant difference in CIN incidence between the statin and placebo groups (6.5% vs. 7.2%) (RR = 0.89, 0.46 - 1.73), without evidence of heterogeneity (I² = 0%, p = 0.79). The remaining three studies conducted in patients with CKD Stage > 3 revealed a significantly lower CIN incidence in the statin groups (3.6% vs. 11.9%) (RR = 0.28, 0.13 - 0.62), without evidence of heterogeneity (I2 = 0%, p = 0.87).
  
  
  CONCLUSIONS
  The overall effect of shortterm, high-dose statin treatment seems to be helpful for prevention of CIN. However, the subgroup analysis shows statin benefit only in patients with CKD Stage > 3, but not in patients with CKD Stage ≤ 3.
  
  
  CONCLUSIONS
  The relative low quality of the individual studies and limited studies means that only a limited conclusion on the use of statin for prevention of CIN was possible.
authors: Department of Nephrology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Y
authors: Y
authors: Zhou
authors: W J
authors: WJ
authors: Yuan
authors: N
authors: N
authors: Zhu
authors: L
authors: L
authors: Wang
mesh_terms: D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic
chemical_list: D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors