title: Periprocedural Nebivolol for the Prevention of Contrast-Induced Acute Kidney Injury: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Nebivolol provides a protective effect on contrast-induced acute kidney injury (CIAKI) in animal models. However, the reports on the efficacy of nebivolol for the prevention of CIAKI in human remain unclear.
  
  
  OBJECTIVE
  The objective of this meta-analysis was to assess the effect of nebivolol for the prevention of CIAKI.
  
  
  METHODS
  Comprehensive literature searches were performed using MEDLINE, EMBASE, and Cochrane Database from inception through February 2015. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of CIAKI in patients who received nebivolol versus those who did not were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.
  
  
  RESULTS
  Four studies (2 randomized controlled trials and 2 cohort studies) with 543 patients were included in our analysis to assess the risk of CIAKI and the use of nebivolol. Patients in the nebivolol group had an overall lower incidence of CIAKI (14.4%) compared to the control group (18.4%). The pooled RR of CIAKI in patients receiving nebivolol was 0.66 (95% CI: 0.38-1.15, I (2) = 0). When meta-analysis was limited only to randomized control trials (RCTs), the pooled RR of CIAKI in patients receiving nebivolol was 0.79 (95% CI: 0.35-1.79, I (2) = 0%).
  
  
  CONCLUSIONS
  Despite no statistical significance, there was a trend toward reduced CIAKI risk in patients receiving nebivolol. The findings of our meta-analysis suggest the need of a large RCT with very careful attention to the balance of benefits and harms.
authors.affiliation: Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
authors.forename: Natanong
authors.initials: N
authors.lastname: Thamcharoen
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Charat
authors.initials: C
authors.lastname: Thongprayoon
authors.affiliation: Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Edmonds
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Wisit
authors.initials: W
authors.lastname: Cheungpasitporn
keywords: B-Blocker; contrast-induced acute kidney injury; contrast-induced nephropathy; meta-analysis; nebivolol