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Submitted: 20 Oct 2024
Accepted: 05 Dec 2024
ePublished: 28 Dec 2024

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Cited By

J Nephropharmacol. 2025;14(1): e12755.
doi: 10.34172/npj.2025.12755
  Abstract View: 180
  PDF Download: 96

Meta Analysis

Relationship between systemic immune-inflammation Index and contrast-induced acute kidney injury in cardiovascular patients: systematic review and meta-analysis

Mohammad Rostamzadeh 1 ORCID logo, Sholeh Ghasemi 2 ORCID logo, Amir Heidari 3 ORCID logo, Maytham Hameed Al-Qanbar 4 ORCID logo, Maedeh Golnavaz 5 ORCID logo, Roozbeh Roohinezhad 6 ORCID logo, Nadia Pourghaz 7 ORCID logo, Negar Jafari 8 ORCID logo, Reza Faramarzzadeh 9* ORCID logo

1 Department of Cardiology, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
3 Department of Cardiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 College of Medicine, University of Al-Ameed, Karbala, Iraq
5 Faculty of Nursing and Midwifery, North Khorasan University of Medical Science, Bojnurd, Iran
6 Department of Urology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
7 Department of Cardiology, Hazrat-e-Rasool Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
8 Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
9 Department of Cardiology, Seyed-Al-Shohada Cardiology Hospital, Urmia University of Medical Sciences, Urmia, Iran
*Corresponding Author: Reza Faramarzzadeh, Email: faramarzzadehreza76@gmail.com

Abstract

Introduction: Contrast-induced acute kidney injury (CI-AKI) imposes high costs and various complications on individuals and society. Considering that inflammation is a significant risk factor for CI-AKI incidence, the present research aimed to investigate the relationship between the systematic immune-inflammation (SII) index and the CI-AKI risk in cardiovascular patients using the systematic review and meta-analysis method.

Materials and Methods: In the present study, ProQuest, PubMed, Embase, Web of Science, Cochrane, Scopus, and Google Scholar databases were used to search for articles published until October 16, 2024. Data analysis was conducted using the STATA 14 software, and tests with P values < 0.05 were considered statistically significant.

Results: There was no significant association between the SII index and risk of CI-AKI in patients who underwent carotid artery angiography (OR: 1; 95% CI: 1, 1.01) or coronary angiography (OR: 1.96; 95% CI: 0.94, 4.11). However, in patients undergoing percutaneous coronary intervention (PCI) (OR: 1.01; 95% CI: 1, 1.02), high SII index levels increased the risk of CI-AKI. High SII index levels (OR: 1.01; 95% CI: 1.01, 1.02), higher ages (OR: 1.04; 95% CI: 1.02, 1.06), high-sensitivity C-reactive protein (hs-CRP) (OR: 1.01; 95% CI: 1, 1.02), hypertension (OR: 1.63; 95% CI: 1.31, 2.03), diabetes mellitus (OR: 1.73; 95% CI: 1.12, 2.68), neutrophil to lymphocyte ratio (NLR) (OR: 1.09; 95% CI: 1.01, 1.17), and neutrophil count (OR: 1.12; 95% CI: 1.08, 1.16) increased the risk of CI-AKI in cardiovascular patients. On the other hand, estimated glomerular filtration rate (eGFR) (OR: 0.98; 95% CI: 0.98, 0.99), lymphocyte count (OR: 0.47; 95% CI: 0.31, 0.71), and hemoglobin (OR: 0.97; 95% CI: 0.96, 0.98), albumin (OR: 0.96; 95% CI: 0.93, 0.99) in individuals with CIN were lower than those in the no-CIN group.

Conclusion: High systemic immune-inflammation index levels, age, NLR, hs-CRP, hypertension, diabetes mellitus, and neutrophil count were among the risk factors of CI-AKI incidence in cardiovascular patients.

Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024604243) and Research Registry (UIN: reviewregistry1904) website.

Implication for health policy/practice/research/medical education:

In a review of 15 studies, several key risk factors were identified as significant contributors to the incidence of contrast-induced acute renal failure among cardiovascular patients, including high levels of the systemic immune-inflammation index, age, neutrophil to lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), hypertension, diabetes mellitus, and neutrophil count. The systemic immune-inflammation index, which is calculated as the product of neutrophil count and platelet count divided by lymphocyte count, serves as a crucial marker of systemic inflammation and has been associated with adverse renal outcomes following contrast exposure. Older age was found to increase susceptibility to contrast-induced acute kidney injury (CI-AKI), while elevated neutrophil-to-lymphocyte ratio and C-reactive protein levels further indicated heightened inflammatory states that correlate with kidney injury risk. Additionally, the presence of comorbid conditions such as hypertension and diabetes mellitus significantly exacerbated the likelihood of developing CI-AKI. An increased neutrophil count also contributed to this risk profile, underscoring the importance of monitoring these inflammatory and clinical parameters in cardiovascular patients undergoing procedures involving contrast agents to effectively mitigate the risk of acute kidney injury.

Please cite this paper as: Rostamzadeh M, Ghasemi Sh, Heidari A, Hameed Al-Qanbar M, Golnavaz M, Roohinezhad R, Pourghaz N, Jafari N, Faramarzzadeh R. Relationship between systemic immune-inflammation Index and contrast-induced acute kidney injury in cardiovascular patients: systematic review and meta-analysis. J Nephropharmacol. 2025;14(1):e12755. DOI: 10.34172/npj.2025.12755.

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