TY - JOUR
T1 - Acute Kidney Injury from Intravitreal Anti-vascular Endothelial Growth Factor Drugs
T2 - A Systematic Review and Meta-analysis of Randomized Controlled Trials
AU - Tsao, Yu Chien
AU - Chen, Ting Ying
AU - Wang, Li An
AU - Lee, Chia Chun
AU - Lee, Wan Ju Annabelle
AU - Hsu, Sheng Min
AU - Lai, Chi Chun
AU - Shao, Shih Chieh
AU - Hung, Jia Horung
AU - Lai, Edward Chia Cheng
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2023/11
Y1 - 2023/11
N2 - 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, I 2: 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, I 2: 0% for aflibercept; OR: 0.97, 95% CI 0.42–2.22, I 2: 0% for ranibizumab) and between different retinal diseases (OR: 4.61, 95% CI 0.07–284.13, I 2: not applicable for age-related macular degeneration; OR: 0.90, 95% CI 0.42–1.93, I 2: 0% for diabetic retinopathy/diabetic macular edema; OR: 1.57, 95% CI 0.16–15.88, I 2: 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.
AB - 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, I 2: 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, I 2: 0% for aflibercept; OR: 0.97, 95% CI 0.42–2.22, I 2: 0% for ranibizumab) and between different retinal diseases (OR: 4.61, 95% CI 0.07–284.13, I 2: not applicable for age-related macular degeneration; OR: 0.90, 95% CI 0.42–1.93, I 2: 0% for diabetic retinopathy/diabetic macular edema; OR: 1.57, 95% CI 0.16–15.88, I 2: 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.
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U2 - 10.1007/s40259-023-00621-6
DO - 10.1007/s40259-023-00621-6
M3 - Review article
C2 - 37676536
AN - SCOPUS:85169882344
SN - 1173-8804
VL - 37
SP - 843
EP - 854
JO - BioDrugs
JF - BioDrugs
IS - 6
ER -
