The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.
OBJECTIVE
The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury.


METHODS
A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method.


RESULTS
Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62).


CONCLUSIONS
Our meta-analysis shows no significant association between contrast media volume and risk of acute kidney injury after transcatheter aortic valve replacement.
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Charat
C
Thongprayoon
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Wisit
W
Cheungpasitporn
Department of Hospital Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Alexander J
AJ
Podboy
Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.
Erin A
EA
Gillaspie
Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.
Kevin L
KL
Greason
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN.|Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Kianoush B
KB
Kashani
D058186:Acute Kidney Injury / Q000209:etiology*; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D017594:Publication Bias; D012306:Risk; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
D003287:Contrast Media
Acute kidney injury; TAVI; TAVR; contrast; transcatheter aortic valve replacement