Currently, it has not been determined whether adenosine receptor antagonists such as theophylline can prevent contrast agent acute kidney injury. The databases MEDLINE (1966 to July 2011), EMBASE (1980 to July 2011), Web of Science (1986 to July 2011) and the Cochrane Central Register of Controlled Trials (1996 to July 2011) are searched here, and there are no language restrictions. Meta analysis of the therapeutic effects of using and not using adenosine antagonist N-acetylcysteine. The article was published in the American Journal of Nephrology.
Results A total of 16 trials were enrolled. A total of 1412 participants showed that theophylline significantly reduced the risk of contrast agent AKI (13 trials, 1222 patients, hazard ratio 0.48) and absolute changes in serum creatinine concentrations. There was a protective effect (13 trials, 1170 patients, mean SD difference was −0.31 mg/dL). Meta-analysis showed that contrast-related nephropathy-associated risk was significantly associated with baseline serum creatinine levels and Jadad scores, but there was no significant effect on dialysis treatment risk and in-hospital mortality.
Thus, theophylline treatment can significantly reduce the risk of contrast agent AKI, and also slightly improve renal function in people exposed to contrast agents, but this protection is at a higher basal serum creatinine level (creatinine ≥ 1.5 mg /dL) is not reflected in patients. In addition, the long-term therapeutic effect of theophylline on contrast agent AKI is unknown. In the future, large-scale sample observation studies of contrast agents AKI at different risk levels are needed to assess the true efficacy.
Results A total of 16 trials were enrolled. A total of 1412 participants showed that theophylline significantly reduced the risk of contrast agent AKI (13 trials, 1222 patients, hazard ratio 0.48) and absolute changes in serum creatinine concentrations. There was a protective effect (13 trials, 1170 patients, mean SD difference was −0.31 mg/dL). Meta-analysis showed that contrast-related nephropathy-associated risk was significantly associated with baseline serum creatinine levels and Jadad scores, but there was no significant effect on dialysis treatment risk and in-hospital mortality.
Thus, theophylline treatment can significantly reduce the risk of contrast agent AKI, and also slightly improve renal function in people exposed to contrast agents, but this protection is at a higher basal serum creatinine level (creatinine ≥ 1.5 mg /dL) is not reflected in patients. In addition, the long-term therapeutic effect of theophylline on contrast agent AKI is unknown. In the future, large-scale sample observation studies of contrast agents AKI at different risk levels are needed to assess the true efficacy.
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