Penggunaan Statin untuk Pencegahan Gagal Ginjal Akut Akibat Kontras

Oleh :

Josephine Darmawan

Studi menunjukkan bahwa statin dapat digunakan untuk mencegah gagal ginjal akut akibat kontras (contrast-induced acute kidney injury / CI-AKI). Meskipun menjanjikan, penggunaannya belum dimasukkan ke dalam pedoman klinis, dan studi lebih lanjut masih diperlukan.

Materi kontras dalam pemeriksaan radiologi semakin banyak digunakan, karena mempermudah diagnosis. Hal ini juga menyebabkan peningkatan berbagai risiko dan efek samping kontras, salah satunya gagal ginjal akut (contrast-induced acute kidney injury / CI-AKI).[1,2]

CI-AKI merupakan salah satu penyebab gagal ginjal akut Penyakit ini didefinisikan sebagai kenaikan serum kreatinin atau penurunan laju filtrasi glomerulus dalam waktu 24–72 jam pasca pemberian materi kontras. Kidney Disease Improving Global Outcomes (KDIGO) mendefinisikan CI-AKI sebagai peningkatan kreatinin ≥0,3 mg/dL dari nilai dasar dalam 48 jam setelah terpapar kontras, atau peningkatan kreatinin minimal 1,5 kali di atas nilai dasar dalam 7 hari.[2,3]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Ozkok S, Ozkok A. Contrast-induced acute kidney injury: A review of practical points. World J Nephrol. 2017;6:86.
2. Chandiramani R, Cao D, Nicolas J, Mehran R. Contrast-induced acute kidney injury. Cardiovasc Interv Ther. 2020 Jul;35(3):209-217. doi: 10.1007/s12928-020-00660-8.
3. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120:c179–84.
4. Morcos R, Kucharik M, Bansal P, Al Taii H, Manam R, Casale J, Khalili H, Maini B. Contrast-Induced Acute Kidney Injury: Review and Practical Update. Clin Med Insights Cardiol. 2019 Nov 1;13:1179546819878680. doi: 10.1177/1179546819878680.
5. Rosner MH. Prevention of Contrast-Associated Acute Kidney Injury. N Engl J Med. 2018;378:671–2.
6. Neumann FJ, Sousa-Uva M, Ahlsson A, et al; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019 Jan 7;40(2):87-165. doi: 10.1093/eurheartj/ehy394.
7. Cho A, Lee YK, Sohn SY. Beneficial effect of statin on preventing contrast-induced acute kidney injury in patients with renal insufficiency: A meta-analysis. Medicine (Baltimore). 2020 Mar;99(10):e19473. doi: 10.1097/MD.0000000000019473.
8. Liu LY, Liu Y, Wu MY, Sun YY, Ma FZ. Efficacy of atorvastatin on the prevention of contrast-induced acute kidney injury: a meta-analysis. Drug Des Devel Ther. 2018;12:437–44.
9. Ando G, Cortese B, Russo F, Rothenbhler M, Frigoli E, Gargiulo G, et al. Acute kidney injury after radial or femoral access for invasive acute coronary syndrome management AKI-MATRIX. J Am Coll Cardiol. 2017;69:2592–603.
10. Su X, Xie X, Liu L, Lv J, Song F, Perkovic V, et al. Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-analysis. Am J Kidney Dis. 2017;69:69–77.
11. Lin M, Xu T, Zhang W, Li D, et al. Effect of statins on post-contrast acute kidney injury: a multicenter retrospective observational study. Lipids Health Dis. 2021 Jul 5;20(1):63. doi: 10.1186/s12944-021-01489-7.
12. Wang X, Zhang T, Hu L, Sun S, Zhang W, Sun Z, et al. Comparison of Effects of Different Statins on Contrast-Induced Acute Kidney Injury in Rats: Histopathological and Biochemical Findings. Oxid Med Cell Longev. 2017;2017:1–10.
1. Ozkok S, Ozkok A. Contrast-induced acute kidney injury: A review of practical points. World J Nephrol. 2017;6:86.
2. Chandiramani R, Cao D, Nicolas J, Mehran R. Contrast-induced acute kidney injury. Cardiovasc Interv Ther. 2020 Jul;35(3):209-217. doi: 10.1007/s12928-020-00660-8.
3. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120:c179–84.
4. Morcos R, Kucharik M, Bansal P, Al Taii H, Manam R, Casale J, Khalili H, Maini B. Contrast-Induced Acute Kidney Injury: Review and Practical Update. Clin Med Insights Cardiol. 2019 Nov 1;13:1179546819878680. doi: 10.1177/1179546819878680.
5. Rosner MH. Prevention of Contrast-Associated Acute Kidney Injury. N Engl J Med. 2018;378:671–2.
6. Neumann FJ, Sousa-Uva M, Ahlsson A, et al; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019 Jan 7;40(2):87-165. doi: 10.1093/eurheartj/ehy394.
7. Cho A, Lee YK, Sohn SY. Beneficial effect of statin on preventing contrast-induced acute kidney injury in patients with renal insufficiency: A meta-analysis. Medicine (Baltimore). 2020 Mar;99(10):e19473. doi: 10.1097/MD.0000000000019473.
8. Liu LY, Liu Y, Wu MY, Sun YY, Ma FZ. Efficacy of atorvastatin on the prevention of contrast-induced acute kidney injury: a meta-analysis. Drug Des Devel Ther. 2018;12:437–44.
9. Ando G, Cortese B, Russo F, Rothenbhler M, Frigoli E, Gargiulo G, et al. Acute kidney injury after radial or femoral access for invasive acute coronary syndrome management AKI-MATRIX. J Am Coll Cardiol. 2017;69:2592–603.
10. Su X, Xie X, Liu L, Lv J, Song F, Perkovic V, et al. Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-analysis. Am J Kidney Dis. 2017;69:69–77.
11. Lin M, Xu T, Zhang W, Li D, et al. Effect of statins on post-contrast acute kidney injury: a multicenter retrospective observational study. Lipids Health Dis. 2021 Jul 5;20(1):63. doi: 10.1186/s12944-021-01489-7.
12. Wang X, Zhang T, Hu L, Sun S, Zhang W, Sun Z, et al. Comparison of Effects of Different Statins on Contrast-Induced Acute Kidney Injury in Rats: Histopathological and Biochemical Findings. Oxid Med Cell Longev. 2017;2017:1–10.