Does ascorbic acid protect against contrast-induced acute kidney injury in patients undergoing coronary angiography: a systematic review with meta-analysis of randomized, controlled trials

  • Sadat U
  • Usman A
  • Gillard J
 et al. 
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Abstract

OBJECTIVES: This study sought to perform a systematic review with meta-analysis of randomized controlled trials comparing the use of ascorbic acid with placebo or other treatment options for the treatment of contrast induced-acute kidney injury (CI-AKI) in patients undergoing coronary angiography. BACKGROUND: CI-AKI remains the most widely discussed and debated topic in cardiovascular medicine, with its incidence increasing due to an increasing number of contrast media-enhanced radiological procedures being performed. METHODS: MEDLINE, Embase, and Cochrane central databases were searched from inception to May 2013, without language restrictions. For a study to be selected, it had to report the incidence of CI-AKI as an outcome measure. Studies were excluded if at least 1 study arm did not have ascorbic acid administered alone or with saline solution hydration. Data were extracted by 1 author, and random checks were made by another author. RESULTS: Nine randomized, controlled trials reported data on the incidence of CI-AKI in 1,536 patients who had completed the trial and were included in the final analysis. Patients receiving ascorbic acid had 33% less risk of CI-AKI compared with patients receiving placebo or an alternate pharmacological treatment (risk ratio by random-effects model: 0.672; 95% confidence interval, 0.466 to 0.969; p = 0.034). CONCLUSIONS: Ascorbic acid provides effective nephroprotection against CI-AKI and may form a part of effective prophylactic pharmacological regimens.

Author-supplied keywords

  • Acute Kidney Injury/*chemically induced/epidemiolo
  • Ascorbic Acid/*therapeutic use
  • Ci
  • Ci-aki
  • Confounding Factors (Epidemiology)
  • Contrast Media/*adverse effects/diagnostic use
  • Coronary Angiography/adverse effects/*methods
  • Humans
  • Incidence
  • Odds Ratio
  • Protective Agents/*therapeutic use
  • Randomized Controlled Trials as Topic
  • Rct
  • Research Design
  • Ros
  • Rr
  • Treatment Outcome
  • Vitamins/*therapeutic use
  • acute kidney injury
  • angiography
  • ascorbic acid
  • confidence interval
  • contrast-induced acute kidney injury
  • contrast-induced nephropathy
  • randomized, controlled trial
  • reactive oxygen species
  • risk ratio

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Authors

  • U Sadat

  • A Usman

  • J H Gillard

  • J R Boyle

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