Efficacy of statin pretreatment for the prevention of contrast-induced nephropathy: a meta-analysis of randomised controlled trials.

Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury. Whether additional benefits can be achieved with the use of statin in decreasing the risk of CIN remains undetermined. The purpose of this meta-analysis is to evaluate the effects of statin pretreatment for the prevention of CIN. PubMed, MEDLINE, Web of Science, EMBASE and EBM Reviews databases were searched for randomised controlled trials comparing statin pretreatment with non-statin pretreatment for the prevention of CIN. Two reviewers independently assessed studies and performed data extraction. Risk ratio (RR) or weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using random-effects models. Four trials with 751 subjects were included. Pooled analyses showed that the incidence of CIN was not significantly lower in statin pretreatment group, as compared with control group (RR = 0.76, 95% CI 0.44-1.29, p = 0.30). Similarly, none of 276 patients in statin pretreatment group needed renal replacement therapy (RRT), which was not significantly less than 2 of 275 patients assigned to control group during 1-month follow up (RR = 0.33, 95% CI 0.03-3.17, p = 0.34). Moreover, statin pretreatment was associated with mild reduction of serum creatinine (SCr) (WMD = -0.06 mg/dl, 95% CI -0.12 to 0.00 mg/dl, p = 0.05). The current cumulative evidence suggests that statin pretreatment may neither prevent CIN nor reduce the need for RRT. However, it may slightly decrease the level of SCr.