Effect of Chinese medicine injection for preventing contrast-induced nephropathy after coronary angiography/percutaneous coronary intervention: a systematic review and meta-analysis

Background and aim: With the increasing use of interventional therapy for coronary artery disease (CAD), contrast-induced nephropathy (CIN) has become the third leading cause of hospital-acquired acute renal injury. This meta-analysis aimed to evaluate the efficacy of Chinese medicine injection for preventing CIN. Methods: We retrieved relevant articles published up to August 30, 2017 from five databases: CNKI, Wanfang Data, VIP, PubMed, and Cochrane Controlled Trials Register. Only randomized controlled trials (RCTs) were eligible for inclusion. The fixed-and random-effects models were employed to calculate pooled risk ratios (RRs) and mean differences (MDs), respectively. Results: Thirteen RCTs with a total of 2022 patients were identified. Compared with conventional hydration therapy, Chinese medicine injection significantly reduced CIN incidence (RR: 0.36; 95% CI: 0.26-0.49; P < 0.0001) and improved renal function by lowering serum creatinine at 24 h (MD: -7.03, 95% CI: -10.36, -3.69, P < 0.0001), 48 h (MD: -9.32; 95% CI: -16.32, -2.32; P = 0.009) and 72 h (MD: -8.15; 95% CI: -12.41, -3.89; P = 0.0002) after operation. Furthermore, creatinine clearance at 48 h after operation (MD: 9.57; 95% CI: 3.11, 16.03; P = 0.004) and cystatin C (Cys C) at 24 h after operation (MD: -0.12; 95% CI: -0.14, -0.10; P < 0.0001) were decreased. Conclusion: This meta-analysis demonstrated that Chinese medicine injection lowers CIN incidence, marked by lower levels of Scr, Ccr, and Cys C, in patients undergoing PCI/CAG. However, more rigorously designed studies, with large sample sizes and long-term follow-up, are needed to reach more reliable conclusions.