Table 2.
Subgroups of Studies | Studies Included | Estimated Mean Difference in ΔCr (mg/dl) | 95% CI | P Homogeneity* |
---|---|---|---|---|
Studies included in meta-analysis | 1–4,6–9 | −0.27 | −0.43 to −0.11 | <.01 |
High baseline Cr (Cr ≥2.0) | 3,4,8,9 | −0.36 | −0.63 to −0.09 | <.01 |
Low baseline Cr (Cr<2.0) | 1,2,6,7 | −0.18 | −0.36 to 0.00 | .02 |
High mean contrast volume (vol ≥150 ml) | 2,6,7 | −0.20 | −0.45 to 0.06 | .01 |
Low mean contrast volume (vol<150 ml) | 1,3,4,9 | −0.38 | −0.62 to −0.14 | <.01 |
High mean percentage with diabetes (≥50%) | 3,6 | −0.46 | −0.59 to −0.33 | .29 |
Low mean percentage with diabetes (<50%) | 1,2,7–9 | −0.20 | −0.40 to 0.00 | <.01 |
Studies using 0.9 NS for hydration | 1,2 | −0.15 | −0.31 to 0.01 | .96 |
Studies using 0.45 NS for hydration | 3,4,6–9 | −0.31 | −0.51 to −0.10 | <.01 |
All studies reporting mean difference† | 1–4,6–10,12,15 | −0.28 | −0.43 to −0.13 | <.01 |
Randomized, placebo-controlled† | 1,3,4,6,9 | −0.39 | −0.56 to −0.22 | .01 |
Studies using oral NAC formulation | 1,3–9 | −0.29 | −0.46 to −0.11 | <.01 |
Studies using intra-arterial contrast | 1–8 | −0.22 | −0.38 to −0.06 | <.01 |
Heterogeneity is present when P<.1.
Analysis includes excluded studies.
Cr, creatinine; NAC, N-acetylcysteine; NS, normal saline; CI, confidence interval.
Mean difference change in creatinine, NAC versus placebo. Calculations were done using a random effects model. Study numbers are referenced from Table 1. The quality of studies was not included in the sensitivity analysis because only 1 study fit criteria for high quality. Studies using high doses of oral NAC were not analyzed because only 1 study fit criteria for high-dose oral NAC.