Prevention Strategies for Contrast-Induced Nephropathy
Authors: Steven D. Weisbord, Paul M. Palevsky
Journal: Annals of Internal Medicine (2016)

Letters5 April 2016Prevention Strategies for Contrast-Induced NephropathySteven D. Weisbord, MD, MSc and Paul M. Palevsky, MDSteven D. Weisbord, MD, MScFrom VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.Search for more papers by this author and Paul M. Palevsky, MDFrom VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0098 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Subramaniam and colleagues report the results of a systematic review and meta-analysis funded by the Agency for Healthcare Research and Quality that evaluated specific interventions for prevention of contrast-induced nephropathy (CIN) (1). Of particular interest is their finding that “low-dose N-acetylcysteine compared with IV saline had clinically important and statistically significant benefits.” Careful inspection of the primary studies included in this meta-analysis clearly demonstrates that this is incorrect. Specifically, the authors report that they used “a random-effects model to pool studies comparing N-acetylcysteine with IV [intravenous] saline versus IV saline with or without a placebo.” Thus, among ...References1. Subramaniam RM, Suarez-Cuervo C, Wilson RF, et al. Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis. Ann Intern Med. 2016;164:504-16. [PMID: 26866209]. doi:10.7326/M15-1456 LinkGoogle Scholar2. Palevsky PM, Liu KD, Brophy PD, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury. Am J Kidney Dis. 2013;61:649-72. [PMID: 23499048] doi:10.1053/j.ajkd.2013.02.3493 CrossrefMedlineGoogle Scholar3. Anderson JL, Adams CD, Antman EM, et al; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction. Circulation. 2013;127:e663-828. [PMID: 23630129] doi:10.1161/CIR.0b013e31828478ac CrossrefMedlineGoogle Scholar4. Rudnick M. Prevention of contrast-induced nephropathy. UptoDate. 2015. Google Scholar5. Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. Circulation. 2011;124:e574-651. [PMID: 22064601] doi:10.1161/CIR.0b013e31823ba622 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0098. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffectiveness of Prevention Strategies for Contrast-Induced Nephropathy Rathan M. Subramaniam , Catalina Suarez-Cuervo , Renee F. Wilson , Sharon Turban , Allen Zhang , Cheryl Sherrod , Jonathan Aboagye , John Eng , Michael J. Choi , Susan Hutfless , and Eric B. Bass Prevention Strategies for Contrast-Induced Nephropathy Eric B. Bass Metrics Cited byThe Cause and Treatment of Acute Kidney Injury 5 April 2016Volume 164, Issue 7Page: 511KeywordsCervical intraepithelial neoplasiaClinical trialsDisclosureHealth care qualityHealth services researchIsotonicityOutpatientsResearch quality assessmentSystematic reviews ePublished: 5 April 2016 Issue Published: 5 April 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...