Bainey et al18 | Rosenstock et al17 | Wolak et al16 | Coca et al19 | Goksuluk et al21* | Weisbord et al20 | |
---|---|---|---|---|---|---|
Study design | RCT | RCT | RCT | Prospective cohort | Prospective cohort | Prospective cohort |
Sample size | 208 | 220 | 94 | 1017 | 80 | 44 |
Country | Canada | USA | Israel | North America | Turkey | USA |
Population | Coronary angiography | Coronary angiography | Coronary angiography | Cardiac surgery | Coronary angiography | Coronary angiography |
Risk group | CKD | CKD | None | High risk of AKI | Diabetes | CKD |
Mean age (SD) | Intervention: 73 (9) Control: 72 (8) | Intervention: 72(10) Control: 72 (10) | 65 (12) | Intervention: 71(11) Control: 70 (12) | NR | NR |
Female (%) | 26 | 52 | 33 | 31 | NR | NR |
AKI definition | Increase in SCr ≥25% or ≥0.5 mg from baseline | Increase in SCr >25% or 0.5 mg from baseline | Increase in SCr ≥25% from baseline | Increase in SCr ≥50% or ≥0.3 mg from baseline | Increase in SCr ≥25% or ≥0.5 mg from baseline | Increase in SCr ≥25% from baseline or ≥0.5 mg from baseline |
Comorbidities | Diabetes (54%), hypertension (47%), congestive heart failure (14%), liver cirrhosis (1%) | Hypotension (97%), diabetes (55%) | Diabetes (50%), unstable angina (62%) | Diabetes (47%), Hypertension (88%), congestive heart failure (23%) | Diabetes (100%) | NR |
Study drug | ACE/ARB | ACE/ARB | ACE/ARB | ACE/ARB | ACE/ARB | NSAIDs |
Intervention: timing of hold | 24 hours prior to procedure | Day of procedure | 24 hours prior to procedure | Morning of surgery | 24 hours before procedure | No details |
Intervention: timing of restart | Up to 96 hours postprocedure | 24 hours postprocedure | (1) Immediately afterwards; (2) 24 hours after | No details | No details | No details |
Control | Continued throughout study | Continued throughout study | Continued throughout study | Continued throughout study | Continued throughout study | Continued throughout study |
Risk of bias | Low | Some: randomised by coin toss, no information on allocation concealment. Baseline difference compatible with chance | Some; no information on treatment allocation, baseline difference compatible with chance | Moderate; controlled for confounding but possibility of residual confounding | Critical; no control for confounding | Not assessed |
*Available only as conference abstract.
ACE, angiotensin-converting enzyme inhibitors; AKI, acute kidney infection; ARB, angiotensin receptor blockers; CKD, chronic kidney disease; NSAIDs, non-steroidal anti-inflammatory drugs; RCT, randomised controlled trial; SCr, serum creatinine.