SYSTEMATIC REVIEW article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1608626
This article is part of the Research TopicAdvancing Diagnostic and Therapeutic Approaches for Kidney Dysfunction in Vascular Surgery PatientsView all 3 articles
Saline and N-Acetylcysteine-Based Strategies and Other Approaches to Prevent the Risk of CA-AKI: A Meta-Analysis
Provisionally accepted
- 1Chi Mei Medical Center, Tainan, Taiwan
- 2National Taiwan Normal University, Taipei City, Taipei County, Taiwan
- 3Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
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Background While hydration is currently the most evidence-supported strategy for preventing contrast-associated acute kidney injury (CA-AKI) in patients undergoing cardiovascular angiography, the potential benefits of combining a saline and N-acetylcysteine (NAC) based strategy with additional pharmacologic interventions remain uncertain. Methods We conducted a search for randomized controlled trials (RCTs) in PubMed, Embase, and the Cochrane library from the inception to 26th January 2024. RCTs involving adults undergoing cardiovascular angiography were analyzed, comparing the effects of saline and NAC-based strategies combined with additional agents compared to saline. The primary outcome was the risk of CA-AKI. The comparative effectiveness was visually represented through a network diagram and forest plot, with the treatments ranked by P-score in a league table. Results We included 724 trials with 145,671232 patients, 12,843058 AKI events, comparing 124 different interventions based on hydration and NAC. The incidence of CA-AKI was 12.1.7448% in the hydration with oral NAC group versus 15.494.33% in the hydration with saline alone group (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.623 to 0.97). Compared to individuals with saline
Keywords: Meta-analysis, contrast, Acute kideny injury, Coronary, combined therapy
Received: 09 Apr 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Lin, Tsai, Wu, Pan, Chuang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: I Chen Lin, a8888588885@gmail.com
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