The Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy in Patients Undertaking Coronary Angiography: A Meta-Analysis

Objective To assess the effects of Alprostadil on the prevention of contrast-induced nephropathy（CIN）. Methods We searched WanFang, CNKI, VIP, MEDLINE, Cochrane Library, PubMed, EMBASE, with the key words “alprostadi/prostaglandin E1”、 “contrast” and “nephropathy/nephrosis/nephrotoxicity/kidney failure” in all language from 1996 to 2014 for RCT that assess the prevention effects of Alprostadi on CIN. Results Eight trials with a total of 1 391 patients were identified. Analysis of the data in patients revealed significant difference in CIN incidence between the Alprostadil group and the placebo groups（4.4% vs. 13.8%）. The relative risk RR=0.32, 95%CI（0.22, 0.48）,P<0.000 01 was without evidence of heterogeneity（I²=0,P<0.05）. 48 h levels of ScrMD=-5.19,95%CI（-8.73,-1.65）,P=0.004, 72 h ScrMD=-8.20,95%CI（-13.09,-3.30）,P=0.001, 48 h BUNMD=-1.02,95%CI（-1.65,-0.39）,P=0.001, 72 h BUNMD=-0.68,95%CI（-1.30,0.06）,P=0.03 were significantly lower than in placebo group after PCI（P<0.05）. Conclusion Alprostadil may be beneficial in reducing the incidence of CIN and protect the renal function in CHD patients undergoing PCI.