Objective: To assess the effects of short-term (2 - 7 d) high-dose (80 mg/d) statins in the prevention of contrast-induced nephropathy (CIN).
Methods: We searched PubMed, Embase, Science Direct, Scopus, Ovid and Wiley Inter Science with the key words of "statins/statin/HMG-CoA reductase inhibitor", "contrast" and "nephropathy/nephrosis/nephrotoxicity/kidney failure" in all languages from 1996 to 2010 for RCT that assessed the preventive effect of short-term (2 - 7 d) high-dose (80 mg/d) statins on CIN.
Results: Five trials with a total of 1009 patients were identified. Two studies were conducted in patients with CKD 3-5 stages (GFR ≤ 60 ml/min or serum creatinine ≥ 97.2 µmol/L) and the remaining 3 studies were conducted in patients with CKD 1 and 2 stages. Analysis of the data in patients with CKD 3-5 stages did not reveal a statistically significant difference in CIN incidence between the statins and placebo groups (6.5% vs 7.2%). The relative risk (RR) was 0.89 without evidence of heterogeneity (I(2) = 0%, P = 0.79). Analysis of the data in patients with CKD 1 and 2 stages revealed a significantly lower CIN incidence in the statins group (3.6%) than that in the placebo group (11.9%). The RR was 0.28 without evidence of heterogeneity (I(2) = 0%, P = 0.87).
Conclusion: Short-term high-dose statins treatment may be beneficial in reducing the incidence of CIN in patients with CKD 1 and 2 stages, while no benefit has been shown in the patients with CKD 3-5 stages.