Abstract: Objective  A meta-analysis was conducted to explore the impact of intra-arterial and intravenous injection of contrast agents on the incidence of contrast-induced acute kidney injury (CI-AKI) and its short-term prognosis.  Methods  A comprehensive literature search was conducted in databases such as PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Database, and VIP Database. Meta-analysis was performed using RevMan5.4 software.  Results  According to the inclusion and exclusion criteria, a total of 7 articles were finally included. The total incidence of CI-AKI (OR=1.222, 95% CI: 1.040～1.435, P=0.010) and the incidence of CI-AKI in patients with baseline estimated glomerular filtration rate (eGFR) ≥60 ml/min (OR=1.400, 95% CI: 1.061～1.848, P=0.020) were higher in the intra-arterial angiography group than those in the intravenous angiography group. The all-cause mortality rate was higher in the intravenous angiography group than that in the intra-arterial angiography group (OR=0.471, 95% CI: 0.254～0.872, P=0.020). The average age of the patients was older in the intravenous angiography group than that in the intra-arterial angiography group (MD=-1.139, 95% CI: -1.611～-0.668, P<0.001).  Conclusions  The risk of CI-AKI after intra-arterial injection of contrast agents is higher than that after intravenous injection, but the prognosis of patients is worse in the intravenous angiography group than in the intra-arterial angiography group. The angiography route is one of the risk factors for CI-AKI, suggesting that clinicians should pay attention to the impact of angiography route on the incidence of CI-AKI and the prognosis of patients, and carry out individualized interventions as early as possible to delay the progression of CI-AKI.

Key words: Contrast-induced nephropathy, Acute renal failure, Intra-arterial, Intravenous