Renal replacement therapies in the prevention of contrast-induced acute kidney injury

Table 1 Major randomized controlled trials and meta-analyses on hemodialysis and hemofiltration for contrast-associated acute kidney injury prevention

Ref.	Publication year	Population	Intervention	Comparison	Outcome	Key finding
Sterner et al[20]	2000	Patients with moderately reduced renal function	Hemodialysis	Standard of care	Contrast-associated acute kidney injury	Reduction of contrast media in plasma but no reduction in CA-AKI
Vogt et al[21]	2001	Patients with baseline serum creatinine levels > 2.3 mg/dL	Hemodialysis	Non-hemodialysis	Renal function, hemodialysis requirement, and relevant clinical events	Hemodialysis in all patients with reduced renal function did not improve the rate of CA-AKI
Lehnert et al[22]	1998	Patients with reduced renal function (creatinine 24 mg/dL) undergoing angiography	Hemodialysis for 3 hours as soon as possible after administration of contrast medium	Standard of care	Serum concentrations of contrast medium and creatinine	Hemodialysis eliminates contrast medium effectively. No influence on CA-AKI
Marenzi et al[25]	2006	Patients with chronic kidney disease undergoing percutaneous coronary intervention	Hemofiltration before and after contrast administration	Standard medical care	Contrast-associated acute kidney injury; in-hospital mortality	Contrast-associated acute kidney injury: 3% vs 26%; lower in-hospital mortality in hemofiltration group
Marenzi et al[24]	2003	Patients with chronic kidney disease undergoing percutaneous coronary intervention	Hemofiltration after contrast administration only	Standard medical care	Contrast-associated acute kidney injury	Contrast-associated acute kidney injury: 26% vs 50% in control group
Cruz et al[2]	2012	Meta-analysis on the use of renal replacement therapies for the prevention of CA-AKI	Renal replacement therapies	-	Contrast-associated acute kidney injury	Periprocedural RRT did not decrease the incidence. Hemodialysis increases CA-AKI
Brar et al[17]	2014	High-risk patients undergoing percutaneous coronary intervention - POSEIDON trial	Left ventricular end-diastolic pressure-guided hydration	Standard intravenous hydration	Contrast-associated acute kidney injury	Tailored, hemodynamically guided hydration reduced contrast-associated acute kidney injury incidence
Nijssen et al[15]	2017	Patients with chronic kidney disease undergoing elective procedures - AMACING trial	Standard intravenous hydration	No intravenous hydration	Contrast-associated acute kidney injury; fluid-related adverse events	Increased fluid-related adverse events in low-risk patients receiving routine hydration

CA-AKI: Contrast-associated acute kidney injury; RRT: Renal replacement therapies.