J Korean Med Sci.  2017 Sep;32(9):1468-1473. 10.3346/jkms.2017.32.9.1468.

Could Vitamin E Prevent Contrast-Induced Acute Kidney Injury? A Systematic Review and Meta-Analysis

• Cho MH
• Kim SN
• Park HW
• Chung S
• Kim KS

• KMID: 2385953
• DOI: http://doi.org/10.3346/jkms.2017.32.9.1468

Abstract

Several clinical studies have proposed a protective role for vitamin E (α-tocopherol) against contrast-induced acute kidney injury (CIAKI). The aim of study was to assess the effects of vitamin E for the prevention of CIAKI. A systematic review and meta-analysis was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) reporting the effects of vitamin E on CIAKI development and measurements of renal function were included. Four trials including 623 participants were analyzed in the meta-analysis. All participants received intravenous hydration in addition to vitamin E or placebo. The incidence of the vitamin E group (5.8%) was lower than that of the control group (15.4%). Compared with the control, vitamin E significantly reduced the risk ratio (RR) of CIAKI by 62% (0.38; 95% confidence interval [CI], 0.22, 0.63; P < 0.010). In addition, vitamin E reduced serum creatinine (SCr) increase after contrast administration (standardized mean difference [SMD], −0.27; 95% CI, −0.49, −0.06; P = 0.010). However, changes in glomerular filtration rate (GFR) after contrast administration were not significantly different between vitamin E and the control group (SMD, 0.21; 95% CI, −0.01, 0.43; P = 0.060). Heterogeneity within the available trials was not observed. Our meta-analysis provides evidence that vitamin E plus hydration significantly reduced the risk of CIAKI in patients with renal impairment compared with hydration alone.

Keyword

Acute Kidney Injury; Contrast Media; Meta-Analysis; Vitamin E

MeSH Terms

Acute Kidney Injury*
Contrast Media
Creatinine
Glomerular Filtration Rate
Humans
Incidence
Odds Ratio
Population Characteristics
Vitamin E*
Vitamins*
Contrast Media
Creatinine
Vitamin E
Vitamins

Figure

• 

  Fig. 1 Flowchart of study selection

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  Fig. 2 The effect of vitamin E on the development of CIAKI. (A) Forest plot of risk ratios in all participants. (B) Forest plot of risk ratios in diabetic participants.CIAKI = contrast-induced acute kidney injury, RR = risk ratio, M-H = Mantel-Haenszel, CI = confidence interval.

• 

  Fig. 3 The effects of vitamin E on measurements of renal function. (A) Forest plot of differences in SCr changes 48 hours after contrast administration between vitamin E and placebo groups. (B) Forest plot of differences in GFR changes 48 hours after contrast administration between vitamin E and placebo groups.SCr = serum creatinine, SD = standard deviation, SMD = standardized mean difference, IV = inverse variance, CI = confidence interval.

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