Table_1_Association of N-acetylcysteine use with contrast-induced nephropathy: an umbrella review of meta-analyses of randomized clinical trials.docx

BackgroundThe effectiveness of N-acetylcysteine (NAC) in treating contrast-induced nephropathy (CIN) has been the subject of conflicting meta-analyses, but the strength of the evidence for these correlations between NAC use and CIN has not been measured overall.ObjectiveTo evaluate the data from randomized clinical studies (RCTs) that examined the relationships between NAC use and CIN in meta-analyses.MethodsBetween the creation of the database and April 2023, searches were made in PubMed, Cochrane Library, EMBASE, and Web of Science. N-acetylcysteine, contrast-induced nephropathy, or contrast-induced renal disease were among the search keywords used, along with terms including systematic review and meta-analysis. The Assessment of Multiple Systematic Reviews, version 2, which assigned grades of extremely low, low, moderate, or high quality to each meta-analysis’s scientific quality, was used to evaluate each meta-analysis. The confidence of the evidence in meta-analyses of RCTs was evaluated using the Grading of Recommendation, Assessment, Development and Evaluations method, with evidence being rated as very low, low, moderate, or high.ResultsIn total, 493 records were screened; of those, 46 full-text articles were assessed for eligibility, and 12 articles were selected for evidence synthesis as a result of the screening process. Based on the pooled data, which was graded as moderate-quality evidence, it can be concluded that NAC can decrease CIN (OR 0.72, 95% CI 0.65–0.79, p

背景：N-乙酰半胱氨酸（NAC）在治疗对比剂诱导的肾病（CIN）方面的有效性一直是争议的焦点，然而，关于NAC使用与CIN之间相关性的证据强度尚未得到总体评估。目的：评估随机临床试验（RCTs）中的数据，以元分析的形式研究NAC使用与CIN之间的关系。方法：自数据库建立至2023年4月，在PubMed、Cochrane图书馆、EMBASE和Web of Science中进行搜索。搜索关键词包括N-乙酰半胱氨酸、对比剂诱导的肾病或对比剂诱导的肾疾病，以及系统综述和元分析等术语。使用《多重系统综述评估》第二版对每个元分析的科学研究质量进行分级，以评估每个元分析。采用《建议、评估、发展和评价分级法》对RCTs的元分析中证据的置信度进行评估，证据等级被评为非常低、低、中等或高。结果：共筛选出493条记录；其中，46篇全文文章被评估是否符合资格，经过筛选过程，最终有12篇文章被选用于证据综合。基于质量被评为中等的汇总数据，可以得出结论：NAC可以降低CIN的风险（OR 0.72，95% CI 0.65–0.79，p