The Relative Renal Safety of Iodixanol Compared With Low-Osmolar Contrast MediaA Meta-Analysis of Randomized Controlled Trials
Michael Reed, MD*,
Pascal Meier, MD*,
Umesh U. Tamhane, MD*,
Kathy B. Welch, MS, MPH ,
Mauro Moscucci, MD ,
Hitinder S. Gurm, MD*,*
* University of Michigan School of Medicine, VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor, Michigan
Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan
University of Miami, Miami, Florida
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Figure 1 Flow Diagram of Selection Strategy
Flow diagram depicting the selection strategy for trials used in this meta-analysis. CI-AKI = contrast-induced acute kidney injury; LOCM = low-osmolar contrast media.
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Figure 2 Forest Plot of RR of CI-AKI
Forest plot of risk ratios (RR) of contrast-induced acute kidney injury (CI-AKI) of pooled trials. Total number of patients in iodixanol group = 1,291. Total number of patients in the low-osmolar contrast media (LOCM) group = 1,289. ACTIVE = Abdominal Computed Tomography: IOMERON 400 versus VISIPAQUE 320 Enhancement Study; CARE = Cardiac Angiography in Renally Impaired Patients Study; CI = confidence interval; ICON = Ionic Versus Nonionic Contrast to Obviate Worsening Nephropathy After Angioplasty in Chronic Renal Failure Patients; IMPACT = renally IMpaired PAtients undergoing Computed Tomography; IX = iodixanol; NEPHRIC = Nephrotoxicity in High-Risk Patients Study of Iso-Osmolar and Low-Osmolar Non-Ionic Contrast Media Study; PREDICT = Patients with Renal Impairment and Diabetes undergoing Computed Tomography; RECOVER = Renal Toxicity Evaluation and Comparison Between Visipaque and Hexabrix in Patients With Renal Insufficiency Undergoing Coronary Angiography; VALOR = Visipaque Angiography/Interventions With Laboratory Outcomes in Renal Insufficiency Study.
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Figure 3 Forest Plot of RR of CI-AKI of Patients Undergoing Coronary Angiography
Forest plot of risk ratios (RR) of contrast-induced acute kidney injury (CI-AKI) in studies of patients undergoing coronary angiography. Total number of patients in iodixanol group = 873. Total number of patients in the low-osmolar contrast media (LOCM) group = 875. Abbreviations as in Figures 1 and 2.
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Figure 4 Forest Plot of RR of CI-AKI by Contrast Media
Forest plot of risk ratios of contrast-induced acute kidney injury. Analyses stratified by the different low-osmolar contrast media compared with iodixanol. Abbreviations as in Figures 2 and 3.
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