Contrast-induced nephropathy continues to pose a serious risk in coronary interventions, particularly for individuals with existing kidney dysfunction. A meta-analysis published in BMC Nephrology shows that Nicorandil can significantly reduce this risk and support early renal function stability.

The analysis pooled 11 randomized controlled trials including 2837 adults undergoing coronary procedures. Compared with control treatment, Nicorandil significantly reduced CIN incidence (risk ratio 0.37, 95% CI 0.27 to 0.49, P<0.001). Nicorandil also attenuated the rise in serum creatinine at 24 hours (mean difference –4.45 µmol/L, P=0.01), 48 hours (–5.57 µmol/L, P<0.001), and 72 hours (–5.70 µmol/L, P=0.004).

In contrast, eGFR did not differ significantly between the Nicorandil and control groups at 24, 48, or 72 hours, with mean differences within a narrow range and P values above 0.05. Rates of major adverse events, including stroke, myocardial infarction, emergency percutaneous coronary intervention, and need for dialysis, were similar across treatment arms.

These results indicate that Nicorandil offers a favorable renal safety profile and provides clinically meaningful protection against CIN in patients undergoing coronary interventions.