: Background: Contrast-induced nephropathy (CIN) is a relevant cause of acute renal dysfunction and is associated with an increased morbidity and mortality. Purpose: Verify the effect of α-tocopherol pre-treatment on CIN prevention in subjects with chronic kidney disease. Methods: A Medline/Embase and clinicaltrials.gov were searched up to May 1st, 2017. Randomized controlled trials recruiting patients undergoing diagnostic or therapeutic radiocontrast infusion comparing the effect of either oral or i.v. multiple administration of pharmacological dose of α-tocopherol in preventing CIN versus placebo were included. A random-effects model, calculating Mantel-Haenszel odds ratio with 95% confidence interval, was applied to study the effect of α-tocopherol on CIN occurrence. Funnel plot analysis was used to assess publication bias, while agreement within studies was measured by the I2 index and tested with the Q-Cochran test. Results: Out of 242 studies, 4 trials were selected. CIN incidence resulted significantly lower in α-tocopherol compared to placebo group (5.8% vs. 15.4%, MH-OR [95% C.I.] 0.34 [0.19 - 0.59]). Alpha-tocopherol treatment was associated with both a tendential higher eGFR (mean difference 2.19 [95% C.I. -0.41; 4.79] mL/min) and lower creatinine level (mean difference -0.06 [95% C.I. -0.21; 0.09] mg/dl) compared to placebo. No relevant publication bias (p = 0.48) and heterogeneity (I2 = 0%; χ2 = 1.01, df = 3 [p = 0.80], I2 = 0%) were evident. Conclusions: Alpha-tocopherol pre-treatment is associated with reduction of incidence of CIN. Its administration deserves to be further explored as a simple and inexpensive tool for CIN prevention.

Alpha-Tocopherol and contrast-induced nephropathy: a meta-analysis of randomized controlled trials / Monami, Matteo; Cignarelli, Angelo; Pinto, Sara; D'Onofrio, Luca; Milluzzo, Agostino; Miccoli, Roberto; Penno, Giuseppe; Mannucci, Edoardo (Young Academy Group). - In: INTERNATIONAL JOURNAL FOR VITAMIN AND NUTRITION RESEARCH. - ISSN 0300-9831. - 91:1-2(2019), pp. 188-196. [10.1024/0300-9831/a000573]

Alpha-Tocopherol and contrast-induced nephropathy: a meta-analysis of randomized controlled trials

D'Onofrio, Luca;
2019

Abstract

: Background: Contrast-induced nephropathy (CIN) is a relevant cause of acute renal dysfunction and is associated with an increased morbidity and mortality. Purpose: Verify the effect of α-tocopherol pre-treatment on CIN prevention in subjects with chronic kidney disease. Methods: A Medline/Embase and clinicaltrials.gov were searched up to May 1st, 2017. Randomized controlled trials recruiting patients undergoing diagnostic or therapeutic radiocontrast infusion comparing the effect of either oral or i.v. multiple administration of pharmacological dose of α-tocopherol in preventing CIN versus placebo were included. A random-effects model, calculating Mantel-Haenszel odds ratio with 95% confidence interval, was applied to study the effect of α-tocopherol on CIN occurrence. Funnel plot analysis was used to assess publication bias, while agreement within studies was measured by the I2 index and tested with the Q-Cochran test. Results: Out of 242 studies, 4 trials were selected. CIN incidence resulted significantly lower in α-tocopherol compared to placebo group (5.8% vs. 15.4%, MH-OR [95% C.I.] 0.34 [0.19 - 0.59]). Alpha-tocopherol treatment was associated with both a tendential higher eGFR (mean difference 2.19 [95% C.I. -0.41; 4.79] mL/min) and lower creatinine level (mean difference -0.06 [95% C.I. -0.21; 0.09] mg/dl) compared to placebo. No relevant publication bias (p = 0.48) and heterogeneity (I2 = 0%; χ2 = 1.01, df = 3 [p = 0.80], I2 = 0%) were evident. Conclusions: Alpha-tocopherol pre-treatment is associated with reduction of incidence of CIN. Its administration deserves to be further explored as a simple and inexpensive tool for CIN prevention.
2019
acute kidney injury; contrast-induced nephropathy; tocopherol; vitamin E
01 Pubblicazione su rivista::01a Articolo in rivista
Alpha-Tocopherol and contrast-induced nephropathy: a meta-analysis of randomized controlled trials / Monami, Matteo; Cignarelli, Angelo; Pinto, Sara; D'Onofrio, Luca; Milluzzo, Agostino; Miccoli, Roberto; Penno, Giuseppe; Mannucci, Edoardo (Young Academy Group). - In: INTERNATIONAL JOURNAL FOR VITAMIN AND NUTRITION RESEARCH. - ISSN 0300-9831. - 91:1-2(2019), pp. 188-196. [10.1024/0300-9831/a000573]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1663161
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