• Umar Sadat, Ammara Usman, Jonathan H Gillard, and Jonathan R Boyle.
• Department of Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Electronic address: sadat.umar@gmail.com.
• J. Am. Coll. Cardiol. 2013 Dec 10;62(23):2167-75.

ObjectivesThis study sought to perform a systematic review with meta-analysis of randomized controlled trials comparing the use of ascorbic acid with placebo or other treatment options for the treatment of contrast induced-acute kidney injury (CI-AKI) in patients undergoing coronary angiography.BackgroundCI-AKI remains the most widely discussed and debated topic in cardiovascular medicine, with its incidence increasing due to an increasing number of contrast media-enhanced radiological procedures being performed.MethodsMEDLINE, Embase, and Cochrane central databases were searched from inception to May 2013, without language restrictions. For a study to be selected, it had to report the incidence of CI-AKI as an outcome measure. Studies were excluded if at least 1 study arm did not have ascorbic acid administered alone or with saline solution hydration. Data were extracted by 1 author, and random checks were made by another author.ResultsNine randomized, controlled trials reported data on the incidence of CI-AKI in 1,536 patients who had completed the trial and were included in the final analysis. Patients receiving ascorbic acid had 33% less risk of CI-AKI compared with patients receiving placebo or an alternate pharmacological treatment (risk ratio by random-effects model: 0.672; 95% confidence interval, 0.466 to 0.969; p = 0.034).ConclusionsAscorbic acid provides effective nephroprotection against CI-AKI and may form a part of effective prophylactic pharmacological regimens.Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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