title: Effect of administration route on the renal safety of contrast agents: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The objective of this study was to examine the association between administration route and relative renal safety of contrast agents.
  
  
  METHODS
  We searched all published articles indexed in Embase, Medline and the Cochrane Central Register of Controlled Trials, from January 1980 to November 2010, to identify relevant studies. Of the 1,047 initially identified studies, 11 randomized controlled trials (RCTs) including 2,210 patients with intra-arterial route and 7 RCTs including 919 patients with intravenous route were finally analyzed.
  
  
  RESULTS
  With regard to intra-arterial route, our meta-analysis showed that iodixanol significantly decreased the risk of contrast-induced acute kidney injury (CI-AKI) when compared with a pool of low-osmolar contrast media (LOCM; risk ratio [RR] = 0.68; 95% confidence interval [95% CI], 0.50-0.92; Z=2.47; p=0.01), with no significant heterogeneity between individual studies (p=0.14, I2=32.4%). However, iodixanol was not associated with a reduction in CI-AKI compared with the LOCM pooled together (RR=0.75; 95% CI, 0.44-1.26; Z=1.10; p=0.27) with intravenous application, again with no significant heterogeneity between individual studies (p=0.40, I2=3.6%).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that administration route may affect the renal safety of contrast agents. Specifically, iodixanol may be a better choice for patients in the interventional cardiology setting.
authors.affiliation: Yu Huang Top Hospital of Yantai, Shan Dong Province, PR China.
authors.forename: Mei
authors.initials: M
authors.lastname: Dong
authors.forename: Zhanquan
authors.initials: Z
authors.lastname: Jiao
authors.forename: Tong
authors.initials: T
authors.lastname: Liu
authors.forename: Fangming
authors.initials: F
authors.lastname: Guo
authors.forename: Guangping
authors.initials: G
authors.lastname: Li
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D004333:Drug Administration Routes; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014283:Triiodobenzoic Acids / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol