Does Ascorbic Acid Protect Against Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography

作者：Sadat Umar^*; Usman Ammara; Gillard Jonathan H; Boyle Jonathan R

来源：Journal of the American College of Cardiology, 2013, 62(23): 2167-2175.

DOI：10.1016/j.jacc.2013.07.065

• acute kidney injury
• angiography
• ascorbic acid
• contrast-induced nephropathy

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.

• 出版日期2013-12-10