scholarly journals Prevalence of contrast nephropathy following the administration of N-acetyl cysteine; a systematic review and meta-analysis

2021 ◽  
Vol 6 (2) ◽  
pp. e34-e34
Author(s):  
Marzieh Khosravani Moghadam ◽  
Hamid Nasri
Keyword(s):  
Systematic Review ◽  
Contrast Media ◽  
Web Of Science ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Contrast Nephropathy ◽  
Contrast Induced Nephropathy ◽  
Prevalence Studies ◽  
Patients With Diabetes ◽  
Acetyl Cysteine

Introduction: Nephropathy is a serious complication in patients receiving contrast during imaging. N-acetyl cysteine (NAC) can reduce the contrast nephropathy. This review evaluates the prevalence of contrast-induced nephropathy (CIN) following the administration of NAC. Methods: A systematic literature search and meta-analysis was conducted in Scopus, Web of Science and PubMed for articles published by December 30, 2019 including the keywords of "N-acetyl cysteine ", "Acute kidney injury", "Nephrotoxicity", "Contrast media", "Contrast-induced AKI" and "Contrast nephropathy". Results: A total of 29 articles of 537 studies examining 5,980 individuals were incorporated in this systematic review and meta-analysis. Pooled estimation of a meta-analysis of prevalence studies reported a prevalence of 9% (0.09), i.e. nine out of every 100 patients undergoing contrast media resulted in CIN but a prevalence of 14% (0.14) was observed in the placebo group. In addition, 41 out of every 100 patients with hypertension undergoing contrast media resulted in CIN (prevalence: 41%) and 64 out of every 100 patients with diabetes undergoing contrast media resulted in CIN (prevalence: 64%). Conclusion: The prevalence of CIN in the group receiving NAC is lower than those who did not receive this drug. Additionally, in patients suffering from diabetes and hypertension, CIN is more prevalent compared to healthy people.

scholarly journals Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tichawona Chinzowu ◽  
Sandipan Roy ◽  
Prasad S. Nishtala
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Acute Kidney Injury ◽  
Web Of Science ◽  
Meta Analysis ◽  
Adult Population ◽  
Kidney Injury ◽  
Organ Injury ◽  
Funnel Plot ◽  
General Adult Population

Abstract Background Older adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects older adults, and hence this vulnerable population is frequently exposed to antimicrobials. There is currently no systematic review summarising the evidence for organ injury risk among older adults following antimicrobial exposure. This systematic review and meta-analysis examined the relationship between antimicrobial exposure and organ injury in older adults. Methodology We searched for original research articles in PubMed, Embase.com, Web of Science core collection, Web of Science BIOSIS citation index, Scopus, Cochrane Central Register of Controlled Trials, ProQuest, and PsycINFO databases, using key words in titles and abstracts, and using MeSH terms. We searched for all available articles up to 31 May 2021. After removing duplicates, articles were screened for inclusion into or exclusion from the study by two reviewers. The Newcastle-Ottawa scale was used to assess the risk of bias for cohort and case-control studies. We explored the heterogeneity of the included studies using the Q test and I2 test and the publication bias using the funnel plot and Egger’s test. The meta-analyses were performed using the OpenMetaAnalyst software. Results The overall absolute risks of acute kidney injury among older adults prescribed aminoglycosides, glycopeptides, and macrolides were 15.1% (95% CI: 12.8–17.3), 19.1% (95% CI: 15.4–22.7), and 0.3% (95% CI: 0.3–0.3), respectively. Only 3 studies reported antimicrobial associated drug-induced liver injury. Studies reporting on the association of organ injury and antimicrobial exposure by age or duration of treatment were too few to meta-analyse. The funnel plot and Egger’s tests did not indicate evidence of publication bias. Conclusion Older adults have a significantly higher risk of sustaining acute kidney injury when compared to the general adult population. Older adults prescribed aminoglycosides have a similar risk of acute kidney injury to the general adult population.

scholarly journals Whether Remdesivir Increases the Risk of Acute Kidney Injury (AKI) in Patients with COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Zhenjian Xu ◽  
Ying Tang ◽  
Qiuyan Huang ◽  
Sha Fu ◽  
Xiaomei Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Disease Severity ◽  
Web Of Science ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Drug Discontinuation ◽  
Common Cause ◽  
Polymerase Inhibitor

Abstract Background: Acute kidney injury (AKI) occurs among patients with COVID-19, it is also proved to be associated with in-hospital mortality. Remdesivir, an RNA polymerase inhibitor, has shown its antiviral activity in vitro and animal models. The adverse effect of Remdesivir especially AKI is the most common cause which lead to drug discontinuation. Whether Remdesivir increases the risk of AKI in patients with COVID-19 is not clear. We conducted a systematic review and meta-analysis to evaluate the incidence rate of AKI in hospitalized COVID-19 patients and whether Remdesivir increases the risk of AKI. Methods: A thorough search was carried out to find relevant studies in PubMed, medRxiv, and Web of Science from 1 Jan 2020 till 1 June 2020. 15135 COVID-19 patients and 981 COVID-19 patients using Remdesivir were included in our meta-analysis. Results: The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 12.0% (95% CI:9.0%-15.0%). According to our subgroup study, the incidence of AKI was associated with the age, disease severity and race of patients. The incidence of AKI in hospitalized COVID-19 patients using Remdesivir was 6% (95% CI: 3%-13%) with a total of 5 studies. Comparing with COVID-19 patients without Remdesivir treatment, Remdesivir treatment do not increase the risk of AKI in COVID-19 patients showing OR 0.80(95%CI: 0.44-1.46, P>0.05). Conclusions: We found out that AKI was not rare in hospitalized COVID-19 patients. The incidence of AKI was associated with age, disease severity and race. Remdesivir treatment did not increase the risk of AKI in hospitalized COVID-19 patients. Our meta-analysis may provide an evidence for future study that AKI is associated with the natural cause of COVID-19, not the adverse event after the usage of Remdesivir.

Prevalence of fatigue after stroke: A systematic review and meta-analysis

2021 ◽  
pp. 239698732110476
Author(s):  
Ibraheem Alghamdi ◽  
Cono Ariti ◽  
Adam Williams ◽  
Emma Wood ◽  
Jonathan Hewitt
Keyword(s):  
Systematic Review ◽  
Healthcare Professionals ◽  
Web Of Science ◽  
Meta Analysis ◽  
Geographical Location ◽  
Prevalence Studies ◽  
High Prevalence ◽  
Fatigue Severity ◽  
Stroke Type ◽  
Review Manager

Background and Purpose Post-stroke fatigue is a debilitating and long-lasting condition. However, there are uncertainties regarding its prevalence and variability between studies. This review aims to estimate the prevalence of fatigue and determine the factors responsible for its variation in the literature. Methods A systematic review was conducted for all published studies (search to November 2020) using AMED, CINAHL, EMBASE, MEDLINE, PsycINFO, SCOPUS and Web of Science. Papers were included if they recruited participants with stroke, used a validated scale to measure fatigue and were in English. Two reviewers screened and assessed the relevant studies for eligibility ( n = 96). The included papers were appraised using the Joanna Briggs Institute (JBI) tool for prevalence studies, and data were extracted by one reviewer. To understand the variation in PSF prevalence between papers, data were pooled and analysed based on relevant methodological (e.g. time of assessment) or clinical factors (e.g. depression) using Review Manager 5.4 software. Results While 48 studies were included and summarised ( N = 9004), only 35 were appropriate for the meta-analysis ( N = 6851). The most frequently used tool to measure fatigue was the Fatigue Severity Scale (FSS) ( n = 31). The prevalence was calculated with a cut-off point of four or more using FSS and resulted in an estimate of 48% (95% CI 42–53%). Time of assessment (<6 vs ≥6 months), stroke type (ischaemic vs haemorrhagic/subarachnoid haemorrhage) and geographical location (East Asia vs Europe) could explain the prevalence variation between studies. Conclusions Fatigue is prevalent among stroke survivors. This condition varies in terms of occurrence between studies; however, time of assessment, stroke type and geographical location might explain this variation. As this review estimates the overall burden of fatigue after stroke, it provides a useful indicator to inform policy, planning and healthcare professionals. Further efforts are required to investigate the mechanisms that lead to PSF, particularly in the groups that show high prevalence, in order to prevent or alleviate it.

Statins and Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 23 (46) ◽  
pp. 7141-7148 ◽  
Author(s):  
Alexandros Briasoulis ◽  
Mohan Pala ◽  
Tesfaye Telila ◽  
Obsinet Merid ◽  
Emmanuel Akintoye ◽  
...  
Keyword(s):  
Systematic Review ◽  
Serum Creatinine ◽  
Enzyme Inhibitors ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Contrast Induced Nephropathy ◽  
Vessel Occlusion ◽  
Iodinated Contrast ◽  
Noninvasive Coronary Angiography ◽  
Increased Risk

Contrast-induced nephropathy (CIN) is a type of acute kidney injury associated with intravascular administration of iodinated contrast, usually reversible. Contrast agents are an essential component of invasive and noninvasive coronary angiography. These agents have been modified over time to enhance patient safety and tolerability, but adverse reactions still occur. CIN has been variably defined, as a rise in serum creatinine of 0.5 mg/dl, or a 25% increase in serum creatinine above baseline within 24-72 hours after the procedure. The incidence of CIN varies based on the definition used and risk profile of the patients. CIN is rare among patients with normal renal function at baseline. In low-risk patients, CIN occurs in 1-5%, whereas in higher-risk populations, the incidence can be as high as 30%. CIN is also associated with a 5- to 20-fold increased risk of other early adverse events including in-hospital myocardial infarction, target vessel occlusion, and early mortality. The main prevention strategies are adequate intravenous hydration before, during and after the procedure as well as restriction of contrast load with maximum volume approximately no more than three times the serum creatinine clearance. Recent observational and small prospective randomized trials demonstrate the reduction of CIN incidence with HMG-CoA enzyme inhibitors. In this systematic review and meta-analysis we explore the effects of statin administration in prevention of CIN.

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