Contrast Media Volume to Creatinine Clearance Ratio in Predicting Nephropathy in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Abstract

The studies investigated the predictive value of the contrast media volume to creatinine clearance ratio (V/CrCl) for contrast-induced nephropathy (CIN) after a percutaneous coronary intervention (PCI) showed conflicting results and different cut-off values. The objective is to evaluate V/CrCl in the prediction of CIN after PCI. PubMed, Embase, and the Cochrane library were searched for eligible studies published from inception to November 2020. The optimal cut-off points of V/CrCl for predicting CIN were examined using odds ratios (ORs) and 95% confidence intervals (CIs). The random-effect model was used for analyses. Six studies (8 datasets, 16 899 patients) were included. V/CrCl was associated with CIN (OR = 2.67, 95% CI: 1.88–3.78, P < .001; I2= 79.3%, Pheterogeneity< .001). V/CrCl was associated with CIN in Asians (OR = 2.13, 95% CI: 1.52–2.98, P = .022; I2= 68.8%, Pheterogeneity< .001) and Europeans (OR = 3.87, 95% CI: 1.77–8.45, P < .001; I2= 85.1%, Pheterogeneity= .001). The association between V/CrCl and CIN was observed in the prospective cohort studies (OR = 2.16, 95% CI: 1.42–3.29, P = .009; I2= 78.9%, Pheterogeneity< .001) and retrospective cohort studies (OR = 3.31, 95% CI: 1.82–6.02, P < .001; I2= 80.6%, Pheterogeneity< .001). The sensitivity analysis showed the results were robust. V/CrCl is independently associated with an increased risk of CIN. V/CrCl could be considered a reliable predictor for the development of CIN in patients undergoing PCI.