RT Journal Article
SR Electronic
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
FD British Cardiovascular Society
SP e000317
DO 10.1136/openhrt-2015-000317
VO 2
IS 1
A1 Shiv Kumar Agarwal
A1 Sameh Mohareb
A1 Achint Patel
A1 Rabi Yacoub
A1 James J DiNicolantonio
A1 Ioannis Konstantinidis
A1 Ambarish Pathak
A1 Shailesh Fnu
A1 Narender Annapureddy
A1 Priya K Simoes
A1 Sunil Kamat
A1 Georges El-Hayek
A1 Ravi Prasad
A1 Damodar Kumbala
A1 Rhanderson M Nascimento
A1 John P Reilly
A1 Girish N Nadkarni
A1 Alexandre M Benjo
YR 2015
UL http://openheart.bmj.com/content/2/1/e000317.abstract
AB 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.