Association of homocysteine and contrast-induced nephropathy: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

XUE Yu ¹ , LI Jingbo ¹ ,  WANG Lina ²

1. Medical School, Southeast University, Nanjing, 210009, P.R.China;
2. School of Public Health, Southeast University, Nanjing, 210009, P.R.China;

Corresponding author：

WANG Lina, Email: lnwang@seu.edu.cn

Keywords：

Homocysteine; Contrast-induced nephropathy; Case-control study; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.201801012

Video：

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ObjectivesTo evaluate the association between high homocysteine (Hcy) levels and risk of contrast-induced nephropathy (CIN).MethodsCNKI, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect the case-control studies on the association between Hcy and risk of CIN from inception to November 30^th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using Stata 12.0 software.ResultsTen case-control studies involving 6 124 subjects were included. Meta-analysis showed that the high Hcy level was associated with an increased risk of CIN (OR=1.59, 95%CI 1.33 to 1.89, P<0.001), and the homocysteine level in CIN group was higher than that in non-CIN group (WMD=8.74, 95%CI 6.18 to 11.31,P<0.001).ConclusionsAccording to the current evidence, the high Hcy level is a risk factor for CIN. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.

Citation： XUE Yu, LI Jingbo, WANG Lina. Association of homocysteine and contrast-induced nephropathy: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2018, 18(7): 700-706. doi: 10.7507/1672-2531.201801012 Copy

1.	Ali-Hasan-Al-Saegh S, Mirhosseini SJ, Ghodratipour Z, et al. Protective effects of anti-oxidant supplementations on contrast-induced nephropathy after coronary angiography: an updated and comprehensive meta-analysis and systematic review. Kardiol Pol, 2016, 74(7): 610-626.
2.	Khatami MR, Sabbagh MR, Nikravan N, et al. The role of neutrophil-gelatinase-associated lipocalin in early diagnosis of contast nephropathy. Indian J Nephrol, 2015, 25(5): 292-296.
3.	Kagan A, Sheikh-Hamad D. Contrast-induced kidney injury: focus on modifiable risk factors and prophylactic strategies. Clin Cardiol, 2010, 33(2): 62-66.
4.	Pushpakumar S, Kundu S, Sen U. Endothelial dysfunction: the link between homocysteine and hydrogen sulfide. Curr Med Chem, 2014, 21(32): 3662-3672.
5.	陈思, 陈韵岱, 钱赓, 等. 急性冠状动脉综合征患者冠脉造影术后对比剂肾病危险因素分析. 中国循证心血管医学杂志, 2016, 8(6): 742-745, 748.
6.	Wells GA, Shea B, O’connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in metaanalyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
7.	Kim SJ, Choi D, Ko YG, et al. Relation of homocysteinemia to contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Am J Cardiol, 2011, 108(8): 1086-1091.
8.	Li S, Tang X, Peng L, et al. A head-to-head comparison of homocysteine and cystatin C as pre-procedure predictors for contrast-induced nephropathy in patients undergoing coronary computed tomography angiography. Clin Chim Acta, 2015, 444: 86-91.
9.	Barbieri L, Verdoia M, Schaffer A, et al. Elevated homocysteine and the risk of contrast-induced nephropathy: a cohort study. Angiology, 2015, 66(4): 333-338.
10.	李顺宝, 苑国富, 于兵, 等. 血 Hcy、Cys-C 对冠脉介入术后对比剂肾病的预测价值. 中国医药导刊, 2015, 17(11): 1115-1117.
11.	席连东, 刘亚娟. 同型半胱氨酸与对比剂肾病的相关性研究. 临床医学专集, 2015, 11: 1193-1194.
12.	鄢高亮, 孔文杰, 王栋, 等. 血浆同型半胱氨酸水平对急性冠状动脉综合征患者经皮冠状动脉介入术后对比剂肾病发生的影响研究. 中华心血管病杂志, 2016, 44(1): 32-37.
13.	徐新娜, 任岚, 王继红, 等. 术前血浆 Hcy 对 CIN 发生的预测价值. 中国医药导刊, 2016, 18(7): 680-681, 683.
14.	艾民, 刘广学, 颜昌福, 等. 血清同型半胱氨酸与冠状动脉造影术后对比剂肾病的相关性研究. 中国介入心脏病学杂志, 2017, 25(3): 144-148.
15.	王群立, 白江涛, 崔展, 等. 血浆同型半胱氨酸水平对老年急性冠状动脉综合征患者经皮冠状动脉介入术后对比剂肾病发生的影响研究. 中国临床医生杂志, 2017, 45(4): 22-26.
16.	王芳, 李鹏, 赵希哲, 等. 血浆 Hcy 对急性心肌梗死患者 PCI 术后发生造影剂肾病的预测价值. 国际检验医学杂志, 2017, 38(19): 2705-2708.
17.	Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol, 2011, 21(12): 2527-2541.
18.	王玉萍, 沈世林, 苏东君, 等. 对比剂肾病研究进展. 介入放射学杂志, 2017, 26(6): 572-575.
19.	Peng HY, Man CF, Xu J, et al. Elevated homocysteine levels and risk of cardiovascular and all-cause mortality: a meta-analysis of prospective studies. J Zhejiang Univ Sci B, 2015, 16(1): 78-86.
20.	Yi F, Li PL. Mechanisms of homocysteine-induced glomerular injury and sclerosis. Am J Nephrol, 2008, 28(2): 254-264.
21.	Fischer PA, Dominguez GN, Cuniberti LA, et al. Hyperhomocysteinemia induces renal hemodynamic dysfunction: is nitric oxide involved? J Am Soc Nephrol, 2003, 14(3): 653-660.
22.	Qin X, Wang Y, Li Y, et al. Risk factors for renal function decline in adults with normal kidney function: a 7-year cohort study. J Epidemiol Community Health, 2015, 69(8): 782-788.
23.	Veeranna V, Zalawadiya SK, Niraj A, et al. Homocysteine and reclassification of cardiovascular disease risk. J Am Coll Cardiol, 2011, 58(10): 1025-1033.

1. Ali-Hasan-Al-Saegh S, Mirhosseini SJ, Ghodratipour Z, et al. Protective effects of anti-oxidant supplementations on contrast-induced nephropathy after coronary angiography: an updated and comprehensive meta-analysis and systematic review. Kardiol Pol, 2016, 74(7): 610-626.
2. Khatami MR, Sabbagh MR, Nikravan N, et al. The role of neutrophil-gelatinase-associated lipocalin in early diagnosis of contast nephropathy. Indian J Nephrol, 2015, 25(5): 292-296.
3. Kagan A, Sheikh-Hamad D. Contrast-induced kidney injury: focus on modifiable risk factors and prophylactic strategies. Clin Cardiol, 2010, 33(2): 62-66.
4. Pushpakumar S, Kundu S, Sen U. Endothelial dysfunction: the link between homocysteine and hydrogen sulfide. Curr Med Chem, 2014, 21(32): 3662-3672.
5. 陈思, 陈韵岱, 钱赓, 等. 急性冠状动脉综合征患者冠脉造影术后对比剂肾病危险因素分析. 中国循证心血管医学杂志, 2016, 8(6): 742-745, 748.
6. Wells GA, Shea B, O’connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in metaanalyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
7. Kim SJ, Choi D, Ko YG, et al. Relation of homocysteinemia to contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Am J Cardiol, 2011, 108(8): 1086-1091.
8. Li S, Tang X, Peng L, et al. A head-to-head comparison of homocysteine and cystatin C as pre-procedure predictors for contrast-induced nephropathy in patients undergoing coronary computed tomography angiography. Clin Chim Acta, 2015, 444: 86-91.
9. Barbieri L, Verdoia M, Schaffer A, et al. Elevated homocysteine and the risk of contrast-induced nephropathy: a cohort study. Angiology, 2015, 66(4): 333-338.
10. 李顺宝, 苑国富, 于兵, 等. 血 Hcy、Cys-C 对冠脉介入术后对比剂肾病的预测价值. 中国医药导刊, 2015, 17(11): 1115-1117.
11. 席连东, 刘亚娟. 同型半胱氨酸与对比剂肾病的相关性研究. 临床医学专集, 2015, 11: 1193-1194.
12. 鄢高亮, 孔文杰, 王栋, 等. 血浆同型半胱氨酸水平对急性冠状动脉综合征患者经皮冠状动脉介入术后对比剂肾病发生的影响研究. 中华心血管病杂志, 2016, 44(1): 32-37.
13. 徐新娜, 任岚, 王继红, 等. 术前血浆 Hcy 对 CIN 发生的预测价值. 中国医药导刊, 2016, 18(7): 680-681, 683.
14. 艾民, 刘广学, 颜昌福, 等. 血清同型半胱氨酸与冠状动脉造影术后对比剂肾病的相关性研究. 中国介入心脏病学杂志, 2017, 25(3): 144-148.
15. 王群立, 白江涛, 崔展, 等. 血浆同型半胱氨酸水平对老年急性冠状动脉综合征患者经皮冠状动脉介入术后对比剂肾病发生的影响研究. 中国临床医生杂志, 2017, 45(4): 22-26.
16. 王芳, 李鹏, 赵希哲, 等. 血浆 Hcy 对急性心肌梗死患者 PCI 术后发生造影剂肾病的预测价值. 国际检验医学杂志, 2017, 38(19): 2705-2708.
17. Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol, 2011, 21(12): 2527-2541.
18. 王玉萍, 沈世林, 苏东君, 等. 对比剂肾病研究进展. 介入放射学杂志, 2017, 26(6): 572-575.
19. Peng HY, Man CF, Xu J, et al. Elevated homocysteine levels and risk of cardiovascular and all-cause mortality: a meta-analysis of prospective studies. J Zhejiang Univ Sci B, 2015, 16(1): 78-86.
20. Yi F, Li PL. Mechanisms of homocysteine-induced glomerular injury and sclerosis. Am J Nephrol, 2008, 28(2): 254-264.
21. Fischer PA, Dominguez GN, Cuniberti LA, et al. Hyperhomocysteinemia induces renal hemodynamic dysfunction: is nitric oxide involved? J Am Soc Nephrol, 2003, 14(3): 653-660.
22. Qin X, Wang Y, Li Y, et al. Risk factors for renal function decline in adults with normal kidney function: a 7-year cohort study. J Epidemiol Community Health, 2015, 69(8): 782-788.
23. Veeranna V, Zalawadiya SK, Niraj A, et al. Homocysteine and reclassification of cardiovascular disease risk. J Am Coll Cardiol, 2011, 58(10): 1025-1033.

Chinese Journal of Evidence-Based Medicine

Association of homocysteine and contrast-induced nephropathy: a meta-analysis

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