PDF(Pubmed)
Abstract：
Contrast-induced nephropathy (CIN) is a serious condition that may develop in patients undergoing diagnostic radiologic procedures. Several treatments have been assessed to prevent CIN development. This study aims to assess the efficacy and safety of vitamin E in the prevention of CIN compared to intravenous (IV) saline hydration. The literature search included MEDLINE/PubMed, Cochrane Central Register of Controlled Trials, the Web of Science, ProQuest, and Scopus for articles published until May 11, 2024, without language or time limits. The outcomes included the incidence of CIN, new-onset dialysis, and death (primary), as well as the change in serum creatinine and glomerular filtration rate (GFR) (secondary). Numerical and dichotomous outcomes were presented as standardized mean difference (SMD) and risk ratio (RR), respectively, with 95% confidence intervals (CI). Six clinical trials were included. Vitamin E was administered orally in varying doses, but one study used IV infusion. Vitamin E decreased the risk of developing CIN by 59% (n=5; pooled RR: 0.41; 95% CI: 0.25, 0.65; P<0.001) compared to IV hydration. None of the patients required renal replacement therapy. One patient on vitamin E died due to the occurrence of acute coronary syndrome. Vitamin E is a promising effective prophylaxis against CIN. However, the number of included studies and their sample sizes are small. The studies showed several limitations. There is a need for further high-quality clinical trials to ascertain the effectiveness of vitamin E compared to IV hydration and to compare vitamin E to other therapies, such as N-acetyl cysteine.
摘要：
造影剂肾病（CIN）是一种严重的疾病，可能会在接受诊断性放射学程序的患者中发展。已经评估了几种预防CIN发展的治疗方法。这项研究旨在评估与静脉（IV）盐水水合相比，维生素E预防CIN的有效性和安全性。文献检索包括MEDLINE/PubMed，Cochrane中央控制试验登记册,WebofScience,ProQuest,和Scopus发表到2024年5月11日的文章，没有语言或时间限制。结果包括CIN的发生率，新的透析，和死亡（主要），以及血清肌酐和肾小球滤过率（GFR）的变化（次要）。数值和二分结果表示为标准化平均差(SMD)和风险比(RR)，分别,95%置信区间(CI)。纳入6项临床试验。维生素E以不同的剂量口服给药，但一项研究使用了静脉输液。与静脉水合相比，维生素E可将CIN的发生风险降低59%（n=5；合并RR：0.41；95%CI：0.25，0.65；P<0.001）。没有患者需要肾脏替代治疗。1例服用维生素E的患者因急性冠脉综合征死亡。维生素E是一种有前途的有效预防CIN。然而,纳入研究的数量和样本量都很小.研究显示了一些局限性。有必要进一步进行高质量的临床试验，以确定维生素E与IV水合相比的有效性，并将维生素E与其他疗法进行比较，例如N-乙酰半胱氨酸。
