Acute Kidney Injury from Intravitreal Anti-vascular Endothelial Growth Factor Drugs: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
BioDrugs
; 37(6): 843-854, 2023 Nov.
Article
em En
| MEDLINE
| ID: mdl-37676536
ABSTRACT
BACKGROUND:
Several observational studies have reported acute kidney injury from intravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs for retinal diseases. However, systematic reviews and meta-analyses of randomized controlled trials on this critical topic are scant.OBJECTIVE:
To evaluate acute kidney injury risk associated with intravitreal anti-VEGF drugs in patients with retinal diseases.METHODS:
We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials on 12 July, 2023, and included randomized controlled trials reporting acute kidney injury between anti-VEGF drugs (e.g., aflibercept, bevacizumab, brolucizumab, and ranibizumab) and controls for retinal diseases (e.g., age-related macular degeneration, polypoidal choroidal vasculopathy, diabetic retinopathy/diabetic macular edema, retinal vein occlusion, and myopic choroidal neovascularization). Data were synthesized by a fixed-effects model for pooling odds ratios (ORs) using the Peto method.RESULTS:
We included 13 randomized controlled trials (four and nine trials for aflibercept and ranibizumab, respectively) with a total of 4282 participants. The meta-analysis indicated intravitreal anti-VEGF drugs did not increase the acute kidney injury risk, compared with controls (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.49-2.04, I2 0%), and no differences in the acute kidney injury risk were observed between different anti-VEGF drugs (OR 1.10, 95% CI 0.27-4.43, I2 0% for aflibercept; OR 0.97, 95% CI 0.42-2.22, I2 0% for ranibizumab) and between different retinal diseases (OR 4.61, 95% CI 0.07-284.13, I2 not applicable for age-related macular degeneration; OR 0.90, 95% CI 0.42-1.93, I2 0% for diabetic retinopathy/diabetic macular edema; OR 1.57, 95% CI 0.16-15.88, I2 0% for retinal vein occlusion).CONCLUSIONS:
Intravitreal anti-VEGF drugs were not associated with an acute kidney injury risk, regardless of which anti-VEGF drugs (aflibercept or ranibizumab) or retinal diseases (age-related macular degeneration, diabetic retinopathy/diabetic macular edema, or retinal vein occlusion) were involved. SYSTEMATIC REVIEW PROTOCOL REGISTRATION PROSPERO CRD42021267854.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Doenças Retinianas
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Oclusão da Veia Retiniana
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Edema Macular
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Retinopatia Diabética
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Injúria Renal Aguda
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Degeneração Macular
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
BioDrugs
Ano de publicação:
2023
Tipo de documento:
Article