title: Periprocedural effects of statins on the incidence of contrast-induced acute kidney injury: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The reports on the efficacy of statins for the prevention of contrast-induced acute kidney injury (CIAKI) remain controversial. The objective of this meta-analysis was to assess the effect of statins for the prevention of CIAKI.
  
  
  METHODS
  Comprehensive literature searches for randomized controlled trials (RCTs) of periprocedural statin treatment for prevention of CIAKI were performed using MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials Systematic Reviews and clinicaltrials.gov from inception until May 2014. The primary outcome was the incidence of CIAKI.
  
  
  RESULTS
  Thirteen prospective RCTs were included in our analysis. Of 5803 patients with contrast exposures, 304 patients (5.2%) had CIAKI. Patients in the statin group had an overall lower incidence of CIAKI (3.6%) compared to the control group (6.9%). Intravenous (IV) fluid hydration was used in both groups of all included studies for prevention of CIAKI. There was a significant protective effect of periprocedural statins on the incidence of CIAKI when compared to the control group [risk ratios (RRs): 0.49; 95% CI: 0.37-0.66, I(2) of 25%].
  
  
  CONCLUSIONS
  Our study demonstrates a statistically significant protective effect of statin treatment during procedures with contrast exposures. This finding suggests the use of statins in addition to standard IV crystalloid hydration may be beneficial in the prevention of CIAKI.
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic , Rochester, MN , USA .
authors.forename: Wisit
authors.initials: W
authors.lastname: Cheungpasitporn
authors.forename: Charat
authors.initials: C
authors.lastname: Thongprayoon
authors.forename: Wonngarm
authors.initials: W
authors.lastname: Kittanamongkolchai
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Edmonds
authors.forename: Oisin A
authors.initials: OA
authors.lastname: O'Corragain
authors.forename: Narat
authors.initials: N
authors.lastname: Srivali
authors.forename: Patompong
authors.initials: P
authors.lastname: Ungprasert
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Erickson
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology* / Q000517:prevention & control*; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D016032:Randomized Controlled Trials as Topic
chemical_list: D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Acute kidney injury; contrast-induced acute kidney injury; contrast-induced nephropathy; meta-analysis; statins