Liwei Liu1,2, Yan Liang3, Huangqiang Li1, Zhubin Lun4, Ming Ying1, Shiqun Chen1, Guanzhong Chen5, Jin Liu1, Yihang Ling1,2, Shaojun Xin1, Jiyan Chen1,2, Yong Liu1,2. 1. Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China. 2. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. 3. Maoming People's Hospital, Maoming, China. 4. Department of Cardiology, Dongguan TMC Hospital, Dongguan, China. 5. Guangdong Provincial People's Hospital affiliated with South China University of Technology, Guangzhou, China.
Abstract
BACKGROUND: Although diabetes mellitus (DM) has been a common risk factor of contrast-associated acute kidney injury (CA-AKI) for a long time, several current studies showed that DM is not an independent risk factor. Due to this diverse finding, we aim to conduct a systematic review assessing the effect of DM on CA-AKI. METHODS: We searched Ovid Medline, Embase, and Cochrane Database of Systematic Reviews (to June 1, 2020) for studies assessing the association between DM and CA-AKI. Random meta-analysis was performed to derive the pooled estimates of the adjusted odds ratio (OR) and corresponding 95% confidence intervals (CIs). RESULTS: A total of 84 studies involving 1,136,827 participants were included in this meta-analysis. The presence of DM was associated with an higher risk of CA-AKI (pooled OR: 1.58, 95% CI: 1.48-1.70, I2 = 64%). Furthermore, the predictive effect of elevated CA-AKI for was stronger in the subgroup of DM patients with chronic kidney disease (CKD) (OR: 2.33, 95% CI: 1.21-4.51), while the relationship between DM and CA-AKI was not significant in subgroup patients without CKD (OR: 1.12, 95% CI: 0.73-1.72). CONCLUSION: This is the first meta-analysis to prove that DM is an independent risk factor of CA-AKI in patients. While the predictive value of DM for CA-AKI in patients with normal kidney function was weakened, more protective treatments are needed in diabetic patients with kidney dysfunction to avoid the occurrence of CA-AKI.
BACKGROUND: Although diabetes mellitus (DM) has been a common risk factor of contrast-associated acute kidney injury (CA-AKI) for a long time, several current studies showed that DM is not an independent risk factor. Due to this diverse finding, we aim to conduct a systematic review assessing the effect of DM on CA-AKI. METHODS: We searched Ovid Medline, Embase, and Cochrane Database of Systematic Reviews (to June 1, 2020) for studies assessing the association between DM and CA-AKI. Random meta-analysis was performed to derive the pooled estimates of the adjusted odds ratio (OR) and corresponding 95% confidence intervals (CIs). RESULTS: A total of 84 studies involving 1,136,827 participants were included in this meta-analysis. The presence of DM was associated with an higher risk of CA-AKI (pooled OR: 1.58, 95% CI: 1.48-1.70, I2 = 64%). Furthermore, the predictive effect of elevated CA-AKI for was stronger in the subgroup of DM patients with chronic kidney disease (CKD) (OR: 2.33, 95% CI: 1.21-4.51), while the relationship between DM and CA-AKI was not significant in subgroup patients without CKD (OR: 1.12, 95% CI: 0.73-1.72). CONCLUSION: This is the first meta-analysis to prove that DM is an independent risk factor of CA-AKI in patients. While the predictive value of DM for CA-AKI in patients with normal kidney function was weakened, more protective treatments are needed in diabetic patients with kidney dysfunction to avoid the occurrence of CA-AKI.