Sodium-glucose cotransporter 2 inhibitors and contrast-induced nephropathy risk: a meta-analysis

Background: Contrast-induced nephropathy (CIN) is an adverse renal event that occurs following the administration of contrast media for diagnostic procedures or therapeutic angiographic intervention. Nevertheless, there is currently no efficacious and safe agents for the treatment of CIN, except for hydration. We aimed to conduct a meta-analysis to verify the potential nephroprotective role of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in the prevention of CIN.

Methods: The PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) databases were searched from their respective inception dates up until 26 August 2024. The "Meta" package of R and Stata software was used for data analysis.

Results: A total of 12 studies were included in the analysis, comprising 11 single-center retrospective studies and one prospective cohort study. Our meta-analysis determined that SGLT2is significantly decrease CIN (odds ratio (OR) 0.39, 95% confidence interval (CI) (0.31, 0.48), P < 0.0001, I² = 0%) and mortality (OR 0.45, 95% CI (0.26, 0.77), P = 0.0039, I² = 48%). No notable discrepancy was discerned in continuous renal replacement therapy (CRRT) (OR 0.53, 95% CI (0.15, 1.91), I² = 0%) or contrast volume (MD - 9.68, 95% CI (- 19.38, 0.03), I² = 71%).

Conclusion: The present study demonstrated that SGLT2is markedly reduce the incidence of contrast-induced nephropathy in diabetic patients. It is recommended that future large-scale randomized controlled trials (RCTs) are required to confirm these findings and to elucidate further the outcomes in patients without diabetes.