Department of Cardiology, JinTan First People's Hospital, Changzhou, China.
Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Cardiology. 2022;147(5-6):469-478. doi: 10.1159/000527384. Epub 2022 Oct 6.
There have been few studies published on the use of contrast media (CM) in metformin-treated patients. In this study, we conducted a systematic review and meta-analysis to investigate the relationship between metformin and contrast-induced acute kidney injury (CI-AKI).
A comprehensive search of the Medline, PubMed, Embase, and Web of Science databases for literature on associations between metformin use and CI-AKI incidence was conducted. The pooled odds ratio (OR), or relative risk, as well as the corresponding 95% confidence intervals (CIs), was calculated to assess the relationship between metformin and CI-AKI risk as well as the incidence of lactic acidosis (LA).
In total, seven studies met our eligibility criteria on associations between metformin use and CI-AKI incidence, comprising 2,325 individuals, with 279 new cases of CI-AKI exposed to CM. The pooled analysis revealed no statistically significant increase in the risk of CI-AKI development in patients who used metformin continuously (random-effects OR: 1.15, 95% CI: 0.70-1.90, p = 0.57). No cases of LA that occurred during CM exposure were reported.
Metformin can be safely used in patients with moderate renal impairment (eGFR ≥ 30 mL/min/1.73 m2) during CM exposure.
关于使用对比剂（CM）在接受二甲双胍治疗的患者中的研究较少。在这项研究中，我们进行了系统评价和荟萃分析，以调查二甲双胍和造影剂引起的急性肾损伤（CI-AKI）之间的关系。
对 Medline、PubMed、Embase 和 Web of Science 数据库中关于二甲双胍使用与 CI-AKI 发生率之间关联的文献进行了全面检索。计算合并的优势比（OR）或相对风险，以及相应的 95%置信区间（CI），以评估二甲双胍与 CI-AKI 风险以及乳酸酸中毒（LA）发生率之间的关系。
共有 7 项研究符合我们关于二甲双胍使用与 CI-AKI 发生率之间关联的入选标准，共纳入 2325 名患者，其中 279 名新发生的 CI-AKI 患者暴露于 CM。荟萃分析显示，连续使用二甲双胍的患者发生 CI-AKI 的风险没有统计学显著增加（随机效应 OR：1.15，95%CI：0.70-1.90，p=0.57）。在 CM 暴露期间未报告发生 LA 的病例。
在 CM 暴露期间，对于 eGFR≥30mL/min/1.73m2 的中度肾功能不全患者，可以安全使用二甲双胍。
