Contrast-induced acute kidney injury in kidney transplant recipients: A systematic review and meta-analysis

Table 1 Main characteristics of the studies included in this meta-analysis[19,30-36]

Characteristics	Light et al[30]	Peters et al[31]	Ahuja et al[32]	Agarwal et al[33]
Country	United States	United States	United States	United States
Year	1975	1983	2000	2009
Total number	34 (very early post-transplant (2-24 d)	93	33	57
Male sex	NR	NR	NR	74%
Mean age (yr)	NR	NR	42 ± 2.1	58.2 ± 10.1
Baseline creatinine (mg/dL)	NR	NR	2.3 ± 0.25	1.7 ± 0.8
Immunosuppression	Azathioprine, methylprednisolone with/without anti-thymocyte globulin	Azathioprine, prednisone with/without anti-thymocyte globulin	Cyclosporine (94%)	Mycophenolate (52.6%), tacrolimus (33.3%), azathioprine (26.3%), sirolimus (1.8%), cyclosporine (52.6%)
Procedure	Drip infusion urogram from 2-24 d post-transplantation	Intravenous pyelogram (87), allograft angiogram (6) during 2 mo post-transplantation	Coronary angiogram (6), CT scan (11), peripheral vascular angiogram (11), allograft angiogram with angioplasty (5), pulmonary angiogram (1), intravenous pyelogram (1)	Cardiac catheterization
Contrast used	30% meglumine diatrizoate	NR	High osmolar contrast (The volume of contrast used was not reported)	Low-osmolar contrast (36), iso-osmolar contrast (21)
Hydration	NR	NR	78.7% of patients received IV hydration	All patients received pre-procedural intravenous hydration with bicarbonate prophylaxis used in 14 patients
CIAKI definition	An increase of SCr > 0.4 mg/dL within 4 d after contrast	Oliguria or increase in creatinine within 12 d after contrast	An increase of SCr > 25% from baseline	An increase in SCr of ≥ 25% or 0.5 mg/dL within 3 d post-catheterization
CIAKI (%)	11 (32.4%)	45 (48.4%)	7 (21.2%) Coronary angiogram 3/6 (50%) Angiogram 2/17 (11.8%) CT 1/11 (9.1%) IVP 1/1 (100%)	9 (15.8%) 13.2% in eGFR < 60% and 21.1% in eGFR > 60%
Dialysis (%)	2 (5.9%)	NR	0 (0%)	1 (1.8%) (temporary dialysis)
Risk factor for CIAKI	CIAKI was more common and more severe in those with impaired kidney function. Kidneys from older donors were at higher risk for CIAKI	CIAKI was common in the early post-transplant period, but no increased risk was found > 120 d post-transplant	IV hydration prior to contrast exposure was protective against CIAKI; 15% of patients who received IV hydration had CIAKI vs 49% in non-IV hydration group	Low osmolar contrast OR 7.75 (1.10-infinity) Use of NAC OR 0.29 (95%CI: 0.04-1.78)
Outcomes	NR	NR	NR	One patient received temporary dialysis

AKI: Acute kidney injury; CIAKI: Contrast-induced acute kidney injury; GFR: Glomerular filtration rate; NAC: N-acetylcysteine; NR: Not reported; SCr: Serum creatinine.