Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603

Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603

Background: Contrast nephropathy is associated with increased in hospital morbidity and mortality and leads to extension of hospital stay in patients with chronic renal insufficiency. Acetylcysteine seems to be a safe and inexpensive way to reduce contrast nephropathy. We aimed to assess the efficac...

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Autores principales: Burotto P,Mauricio, Letelier S,Luz María
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2004
Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000800016
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spelling oai:scielo:S0034-988720040008000162014-08-14Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603Burotto P,MauricioLetelier S,Luz MaríaBackground: Contrast nephropathy is associated with increased in hospital morbidity and mortality and leads to extension of hospital stay in patients with chronic renal insufficiency. Acetylcysteine seems to be a safe and inexpensive way to reduce contrast nephropathy. We aimed to assess the efficacy of acetylcysteine to prevent contrast nephropathy after administration of radiocontrast media in patients with chronic renal insufficiency. Methods: We did a meta-analysis of randomized controlled trials comparing acetylcysteine and hydration with hydration alone for preventing contrast nephropathy in patients with chronic renal insufficiency. The trials were identified through a combined search of the BIOSIS+/RRM, MEDLINE, Web of Science, Current Contents Medizin, and The Cochrane Library Databases. We used incidence of contrast nephropathy 48 h after administration of radiocontrast media as an outcome measure. Findings: Seven trials including 805 patients were eligible according to our inclusion criteria and were analyzed. Overall incidence of contrast nephropathy varied between 8% and 28%. Since significant heterogeneity was indicated by the Q statistics (p=0.016) we used a random effects model to combine the data. Compared with periprocedural hydration alone, administration of acetylcysteine and hydration significantly reduced the relative risk of contrast nephropathy by 56% (0.435 [95% CI 0.215-0.879], p=0.02) in patients with chronic renal insufficiency. Meta-regression revealed no significant relation between the relative risk of contrast nephropathy and the volume of radiocontrast media administered or the degree of chronic renal insufficiency before the procedure. Interpretation: Compared with periprocedural hydration alone, acetylcysteine with hydration significantly reduces the risk of contrast nephropathy in patients with chronic renal insufficiency. The relative risk of contrast nephropathy was not related to the amount of radiocontrast media given or to the degree of chronic renal insufficiency before the procedureinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.8 20042004-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000800016es10.4067/S0034-98872004000800016
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
description Background: Contrast nephropathy is associated with increased in hospital morbidity and mortality and leads to extension of hospital stay in patients with chronic renal insufficiency. Acetylcysteine seems to be a safe and inexpensive way to reduce contrast nephropathy. We aimed to assess the efficacy of acetylcysteine to prevent contrast nephropathy after administration of radiocontrast media in patients with chronic renal insufficiency. Methods: We did a meta-analysis of randomized controlled trials comparing acetylcysteine and hydration with hydration alone for preventing contrast nephropathy in patients with chronic renal insufficiency. The trials were identified through a combined search of the BIOSIS+/RRM, MEDLINE, Web of Science, Current Contents Medizin, and The Cochrane Library Databases. We used incidence of contrast nephropathy 48 h after administration of radiocontrast media as an outcome measure. Findings: Seven trials including 805 patients were eligible according to our inclusion criteria and were analyzed. Overall incidence of contrast nephropathy varied between 8% and 28%. Since significant heterogeneity was indicated by the Q statistics (p=0.016) we used a random effects model to combine the data. Compared with periprocedural hydration alone, administration of acetylcysteine and hydration significantly reduced the relative risk of contrast nephropathy by 56% (0.435 [95% CI 0.215-0.879], p=0.02) in patients with chronic renal insufficiency. Meta-regression revealed no significant relation between the relative risk of contrast nephropathy and the volume of radiocontrast media administered or the degree of chronic renal insufficiency before the procedure. Interpretation: Compared with periprocedural hydration alone, acetylcysteine with hydration significantly reduces the risk of contrast nephropathy in patients with chronic renal insufficiency. The relative risk of contrast nephropathy was not related to the amount of radiocontrast media given or to the degree of chronic renal insufficiency before the procedure
author Burotto P,Mauricio
Letelier S,Luz María
spellingShingle Burotto P,Mauricio
Letelier S,Luz María
Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603
author_facet Burotto P,Mauricio
Letelier S,Luz María
author_sort Burotto P,Mauricio
title Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603
title_short Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603
title_full Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603
title_fullStr Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603
title_full_unstemmed Análisis crítico de un artículo: Acetilcisteína para prevenir falla renal por medio de contraste Birck R, Krzossok S, Markowetz F, Schnulle P, van der Woude FJ, Braun C. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362 (9384): 598-603
title_sort análisis crítico de un artículo: acetilcisteína para prevenir falla renal por medio de contraste birck r, krzossok s, markowetz f, schnulle p, van der woude fj, braun c. acetylcysteine for prevention of contrast nephropathy: meta-analysis. lancet 2003; 362 (9384): 598-603
publisher Sociedad Médica de Santiago
publishDate 2004
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000800016
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