Research: SADAT and COLLEAGUES,

Listed in Issue 245

Abstract

SADAT and COLLEAGUES,  (1)Department of Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. sadat.umar@gmail.com conducted a study 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.

Methodology

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).

Conclusion

Ascorbic acid provides effective nephroprotection against CI-AKI and may form a part of effective prophylactic pharmacological regimens.

References

Sadat U(1), Usman A, Gillard JH, Boyle JR. 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.  J Am Coll Cardiol. 62(23):2167-75. Dec 10 2013. doi: 10.1016/j.jacc.2013.07.065. Epub Aug 28 2013.  Comment in  J Am Coll Cardiol. 62(23):2176-7. Dec 10 2013.

Comment

The above systematic review with meta-analysis of randomized controlled trials demonstrates effective protection (33% less risk) by ascorbic acid (vitamin C) against contrast induced-acute kidney injury (CI-AKI) in patients undergoing coronary angiography.

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