TY - JOUR T1 - Systematic oral hydration with water is similar to parenteral hydration for prevention of contrast-induced nephropathy: an updated meta-analysis of randomised clinical data JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2015-000317 VL - 2 IS - 1 SP - e000317 AU - Shiv Kumar Agarwal AU - Sameh Mohareb AU - Achint Patel AU - Rabi Yacoub AU - James J DiNicolantonio AU - Ioannis Konstantinidis AU - Ambarish Pathak AU - Shailesh Fnu AU - Narender Annapureddy AU - Priya K Simoes AU - Sunil Kamat AU - Georges El-Hayek AU - Ravi Prasad AU - Damodar Kumbala AU - Rhanderson M Nascimento AU - John P Reilly AU - Girish N Nadkarni AU - Alexandre M Benjo Y1 - 2015/10/01 UR - http://openheart.bmj.com/content/2/1/e000317.abstract N2 - Background Contrast-induced nephropathy (CIN) is the third most common cause of hospital-acquired kidney injury and is related to increased long-term morbidity and mortality. Adequate intravenous (IV) hydration has been demonstrated to lessen its occurrence. Oral (PO) hydration with water is inexpensive and readily available but its role for CIN prevention is yet to be determined.Methods PubMed, EMBASE and the Cochrane Central register of controlled trials (CENTRAL) databases were searched until April 2015 and studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All randomised clinical trials with head-to-head comparison between PO and IV hydration were included.Results A total of 5 studies with 477 patients were included in the analysis, 255 of those receiving PO water. The incidence of CIN was statistically similar in the IV and PO arms (7.7% and 8.2%, respectively; relative risk 0.97; 95% CI 0.36 to 2.94; p=0.95). The incidence of CIN was statistically similar in the IV and PO arms in patients with chronic kidney disease and with normal renal function. Rise in creatinine at 48–72 h was lower in the PO hydration group compared with IV hydration (pooled standard mean difference 0.04; 95% CI 0.03 to 0.06; p<0.001; I2=62%).Conclusions Our meta-analysis shows that systematic PO hydration with water is at least as effective as IV hydration with saline to prevent CIN. PO hydration is cheaper and more easily administered than IV hydration, thus making it more attractive and just as effective. ER -