SODIUM-GLUCOSE COTRANSPORTER-2 INHIBITOR FOR PREVENTION OF CONTRAST-INDUCED NEPHROPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS

E-Poster

https://storage.unitedwebnetwork.com/files/1099/1d44520dad594ca7029f504fd761672a.pdf

Abstract Title

First Name *

Jayson

Last Name *

Villavicencio

Co-author 1

Adrian Santos santos.adrianlucas@gmail.com Philippine General Hospital Medicine Manila

Co-author 2

Marissa Elizabeth Lim marlim2006@yahoo.com Philippine General Hospital Medicine Manila

Co-author 3

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Introduction

Contrast-induced nephropathy (CIN) is one of the complications among patients undergoing contrast procedures, particularly those with risk factors. It is now known that sodium-glucose cotransporter-2 (SGLT-2) inhibitor has renoprotective effects. Data on the effectiveness of SGLT-2 inhibitor for prevention of CIN is limited. This study aims to determine the effectiveness of SGLT-2 inhibitor for the prevention of CIN among adult patients given contrast agents for percutaneous coronary intervention.

Methods

A comprehensive search for databases of randomized controlled trials (RCTs) and cohort studies comparing SGLT-2 inhibitor versus without SGLT-2 inhibitor with standard measures for prevention of CIN among adult patients given contrast agents was done. PubMed, EMBASE, Cochrane library, and ClinicalTrials.gov were searched using relevant terms including SGLT-2 inhibitor, CIN or contrast-associated acute kidney injury (AKI) with no date restriction until October 2023. Data extraction was performed using a standardized data form, and any discrepancies were resolved by consensus among the authors. Data pooled using Review Manager Software version 5.4 to determine the risk of developing CIN were analyzed as a meta-analysis and systematic review. ROBINS I tool was used to assess the bias. Heterogeneity was assessed using the I2 test.

Results

One open-label, randomized trial (n=42) and three retrospective observational studies (n=1442) met the eligibility criteria. The SGLT-2 inhibitor group showed decreased risk for CIN (3 studies with 1442 patients; risk ratio, 0.44; 95% CI, 0.30-0.64 p=0.00001). The randomized trial showed no difference in the creatinine 48h post-PCI, with reported incidence of CI-AKI in the SGLT2 inhibitor group versus control at 13.6% and 10.0% respectively, but with no statistical significance.

Conclusions

Current available data supports the use of SGLT-2 inhibitor for the prevention of CIN, particularly in patients undergoing coronary angiography or PCI. More controlled studies are still needed to evaluate further the protective effects of SGLT2 inhibitor for CIN.

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