Penggunaan Statin untuk Pencegahan Gagal Ginjal Akut Akibat Kontras

Oleh :

Josephine Darmawan

Statin telah dilaporkan memiliki efek nefroprotektif, sehingga diduga efektif untuk pencegahan gagal ginjal akut akibat kontras (contrast-induced acute kidney injury / CI-AKI). Meski beberapa penelitian mengindikasikan adanya manfaat penggunaan statin dalam pencegahan gagal ginjal akut akibat kontras, penggunaan statin secara rutin untuk tujuan ini masih kontroversial.[1,2]

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).[3,4]

CI-AKI merupakan salah satu penyebab gagal ginjal akut Penyakit ini didefinisikan sebagai kenaikan kreatinin atau penurunan laju filtrasi glomerulus dalam 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.[4,5]

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

Referensi

1. Elkholy M, Akkawi M, Kidess GG, et al. Efficacy of High-Dose Statins in Preventing Contrast-Induced Nephropathy Post-cardiac Catheterization. Cureus. 2025 Apr 6;17(4):e81795. doi: 10.7759/cureus.81795.
2. Deng C. Contrast-Induced Nephropathy Treatment & Management. 2024. https://emedicine.medscape.com/article/246751-overview
3. Ozkok S, Ozkok A. Contrast-induced acute kidney injury: A review of practical points. World J Nephrol. 2017;6:86.
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5. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120:c179–84.
6. 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.
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8. 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.
9. 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.
10. 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
11. Jones JE, Tuite P, Guttendorf J. Use of Prophylactic High-Dose Statin Therapy to Reduce Contrast-Induced Acute Kidney Injury in Adults Undergoing Acute Coronary Angiography: Evaluation of a Practice Change. Dimens Crit Care Nurs. 2023 Sep-Oct 01;42(5):295-305. doi: 10.1097/DCC.0000000000000599.
12. 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.
13. 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.
14. 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