Journal Article

Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis

Joachim H. Ix, Charles E. McCulloch and Glenn M. Chertow

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 11, pages 2747-2753
Published in print November 2004 | ISSN: 0931-0509
Published online August 2004 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh468
Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis

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Background. Radiocontrast nephropathy is a common cause of acute renal failure in hospitalized patients. Several studies have examined the capacity of theophylline or aminophylline to prevent radiocontrast nephropathy, with conflicting results. We conducted a meta-analysis of published randomized controlled trials to determine if the pre-procedural administration of theophylline or aminophylline prevents radiocontrast-induced declines in kidney function.

Methods. We searched MEDLINE, EMBASE, the Cochrane Collaboration Database, bibliographies of retrieved articles, and consulted with experts to identify relevant studies. Randomized controlled trials of theophylline or aminophylline in hospitalized patients receiving radiocontrast were included. Studies were excluded if they did not report changes in serum creatinine or creatinine clearance within 48 h after radiocontrast exposure.

Results. Seven randomized controlled trials satisfied all inclusion criteria and were included in the analysis (pooled sample size n = 480). The difference in mean change in serum creatinine was 11.5 µmol/l (95% confidence intervals 5.3–19.4 µmol/l, P = 0.004) lower in the theophylline- or aminophylline-treated groups than controls. One participant (0.6%) required dialysis.

Conclusions. Prophylactic administration of theophylline or aminophylline appears to protect against radiocontrast-induced declines in kidney function. Whether these agents reduce the proportion of patients who experience large decrements in serum creatinine concentration, or require dialysis, is unknown.

Keywords: aminophylline; meta-analysis; prevention; radiocontrast nephropathy; theophylline

Journal Article.  3911 words.  Illustrated.

Subjects: Nephrology

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