Preventive effect of nicorandil on contrast‐induced nephropathy: a meta‐analysis of randomised controlled trials

Background Contrast‐induced nephropathy (CIN) is a common and serious side‐effect in patients undergoing angiocardiography or radiological procedures. Aim To assess comprehensively the impact of nicorandil on CIN, by gathering currently available data. Methods We searched three main electric databases (Medline/PubMed, EMBASE and Cochrane Central Register of Controlled Trials) from inception through April 2017. Results Four randomised controlled trials involving 730 participants were included. Pooled estimate showed that nicorandil significantly reduced the rate of CIN by 64% (risk ratio = 0.36, 95% confidence interval (CI): 0.22–0.61, I2 = 31%), compared with control. Nicorandil also significantly decreased serum creatinine level compared with control (mean difference (MD) = −2.70%, 95% CI: −5.21 to −0.20 for percentage change; and standard MD = −0.30, 95% CI: −0.48 to −0.13 for absolute change from baseline). In comparison to control, nicorandil was associated with a non‐significant trend towards decreased cystatin C (MD = −2.18%, 95% CI: −4.39 to 0.02 for percentage change; and MD = −0.08 mg/dL, 95% CI: −0.24 to 0.09 mg/dL for absolute change from baseline). Conclusion Nicorandil can protect renal function and reduce the incidence of CIN in patients exposed to contrast medium. Nicorandil is an additional option in preventing CIN.