Preventive effect of nicorandil on contrast-induced nephropathy: a meta-analysis of randomised controlled trials.

BACKGROUND: Contrast-induced nephropathy (CIN) is a common and serious side-effect in patients undergoing angiocardiography or radiological procedures.

AIM: To assess comprehensively the impact of nicorandil on CIN, by gathering currently available data.

METHODS: We searched three main electric databases (Medline/PubMed, EMBASE and Cochrane Central Register of Controlled Trials) from inception through April 2017.

RESULTS: Four randomised controlled trials involving 730 participants were included. Pooled estimate showed that nicorandil significantly reduced the rate of CIN by 64% (risk ratio = 0.36, 95% confidence interval (CI): 0.22-0.61, I2 = 31%), compared with control. Nicorandil also significantly decreased serum creatinine level compared with control (mean difference (MD) = -2.70%, 95% CI: -5.21 to -0.20 for percentage change; and standard MD = -0.30, 95% CI: -0.48 to -0.13 for absolute change from baseline). In comparison to control, nicorandil was associated with a non-significant trend towards decreased cystatin C (MD = -2.18%, 95% CI: -4.39 to 0.02 for percentage change; and MD = -0.08 mg/dL, 95% CI: -0.24 to 0.09 mg/dL for absolute change from baseline).

CONCLUSION: Nicorandil can protect renal function and reduce the incidence of CIN in patients exposed to contrast medium. Nicorandil is an additional option in preventing CIN.