Introduction: Advanced chronic kidney disease (CKD) patients undergoing percutaneous coronary intervention (PCI) face a high risk of renal injury. Given this vulnerability, zero- and ultra-low-contrast PCI techniques have been proposed to minimize renal damage while still enabling effective revascularization. On this basis, this meta-analysis tests whether these contrast-sparing strategies yield better clinical and renal outcomes compared with conventional PCI in CKD patients. Methods: A total of 3939 records were retrieved from PubMed, Embase, Scopus, ScienceDirect, and Cochrane from inception till November 2025. Eligible RCTs and comparative observational studies reporting renal or cardiovascular outcomes were included. Pooled analyses were conducted in RevMan Web using a random-effects model with p < 0.05 considered statistically significant. Results: Across nine included studies (464,815 patients) evaluating zero-contrast or ultra-low-contrast PCI versus conventional PCI, zero-contrast PCI significantly reduced contrast-induced acute kidney injury (CI-AKI) (OR 0.24, 95% CI 0.12–0.49; p = 0.002), decreased contrast volume (MD −110 mL, 95% CI −168.6 to −51.8; p = 0.005), lowered the need for repeat revascularization (OR 0.26, 95% CI 0.09–0.77; p = 0.005), and reduced the incidence of emergent hemodialysis (OR 0.25, 95% CI 0.13–0.49; p < 0.0001). All-cause mortality and repeat myocardial infarction were initially nonsignificant but became significant after excluding outlier studies (OR 0.49, 95% CI 0.47–0.51; p < 0.00001; OR 0.19, 95% CI 0.10–0.35; p = 0.007, respectively). No significant differences were observed for major adverse cardiovascular events, cardiovascular or non-cardiovascular mortality, renal replacement therapy, or dialysis requirement. Conclusions: Our findings demonstrate that zero- and ultra-low-contrast PCI significantly reduces the risk of CI-AKI while preserving cardiovascular and renal outcomes, supporting its use as a safe and effective alternative to conventional PCI in high-risk CKD patients.

The NHS is facing significant challenges in delivering safe, efficient, and high-quality care due to the fragmentation of patient information. A unified electronic health record (EHR) is essential to address several emerging issues, improve patient safety, and deliver better healthcare. Currently, healthcare professionals must navigate multiple systems to access vital patient data, which can lead to ambiguity, miscommunication, errors, and delays in healthcare provision. A single integrated system will enable real-time access to patient records, preventing misdiagnosis, reducing errors, and treatment delays, ultimately resulting in enhanced patient outcomes. Financially, a unified system would reduce software costs and duplicate investigations, resulting in cost savings that can be reinvested in other areas of healthcare. Moreover, the system would benefit medical research by enabling access to comprehensive patient data for tracking healthcare trends and focusing more on evidence-based practice. The NHS’s centralized structure positions it well for system-wide implementation. Regional pilot projects demonstrate feasibility and offer a roadmap for national rollout. While challenges remain, including funding, training, and data privacy, the long-term benefits far outweigh them. A unified EHR system is a strategic necessity for a safer, more efficient, and equitable NHS.