The prevention of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention.

نویسندگان

  • E Cavusoglu
  • S Chhabra
  • J D Marmur
  • A Kini
  • S K Sharma
چکیده

Contrast-induced nephropathy (CIN) is a leading cause of morbidity and mortality in high-risk patients undergoing percutaneous coronary intervention (PCI) or other radiocontrast procedures. Approximately 25% of all patients selected for these procedures are at risk for its development. Patients who experience this complication have higher rates of mortality, longer hospital stays and poorer long-term outcomes. The occurrence of CIN is directly related to the number of co-existing clinical risk factors. Among the many risk factors, preexisting renal impairment, advanced age, the presence of diabetes mellitus and both the volume and type of the contrast agent administered are among the most important. While the precise pathophysiological mechanisms responsible for this condition are complex and incompletely understood, experimental studies suggest that the pathogenesis involves a combination of renal ischemia and direct tubular epithelial cell toxicity. At the present time, adequate periprocedural hydration and the selection of low-osmolar and, more recently, iso-osmolar contrasts agents are the only available tools to the operator for reducing the risk of this complication. Several other modalities, such as the use of NaHCO3 and hemofiltration, also appear promising in preventing the development of this complication. This article reviews the epidemiology, pathophysiology, and consequences of CIN. It also reviews the risk factors for the development of CIN, as well as the history of the various modalities studied in its prevention.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

A Randomized Double Blind Placebo Controlled Trial Examining the Effects of Pentoxifylline on Contrast Induced Nephropathy Reduction after Percutaneous Coronary Intervention in High Risk Candidates

Contrast-induced nephropathy (CIN) (known as contrast-induced acute kidney injury) occurs as a result of acute worsening of renal function following a procedure with administration of iodine contrasts agent and remains a substantial concern in clinical practices. The purpose of this study is to investigate the preventive effect of Pentoxifylline supplementation on reduction of CIN occurrence af...

متن کامل

A Randomized Double Blind Placebo Controlled Trial Examining the Effects of Pentoxifylline on Contrast Induced Nephropathy Reduction after Percutaneous Coronary Intervention in High Risk Candidates

Contrast-induced nephropathy (CIN) (known as contrast-induced acute kidney injury) occurs as a result of acute worsening of renal function following a procedure with administration of iodine contrasts agent and remains a substantial concern in clinical practices. The purpose of this study is to investigate the preventive effect of Pentoxifylline supplementation on reduction of CIN occurrence af...

متن کامل

بررسی اثرات ان - استیل سیستئین در جلوگیری از نفروپاتی مواد حاجب ناشی از آنژیوگرافی عروق کرونر در افراد با عملکرد کلیوی طبیعی

Background and purpose: N-Acetylcysteine (NAC) has been found to reduce the risk of Contrast Induced Nephropathy (CIN) in chronic renal insufficiency after CT imaging with contrast enhancement. The purpose of the current study was to evaluate the efficacy of NAC, for the prevention of CIN in normal renal functioning patients undergoing coronary angiography. Materials and Methods: We prospe...

متن کامل

Hemofiltration in the prevention of radiocontrast agent induced nephropathy.

AIM The aim of the study was to investigate the role of hemofiltration in preventing contrast nephropathy in patients with renal failure. METHODS We randomized 114 renal failure patients undergoing percutaneous coronary interventions (PCI) to either peri-procedural hemofiltration or saline hydration. RESULTS Contrast nephropathy occurred in 5% of hemofiltration-treated patients and in 50% i...

متن کامل

Efficacy of short-term cordyceps sinensis for prevention of contrast-induced nephropathy in patients with acute coronary syndrome undergoing elective percutaneous coronary intervention.

Contrast-induced nephropathy (CIN) is one of the major causes of hospital-acquired acute renal failure. The pathophysiological mechanism of CIN remains unknown. There has been little evidence regarding the effects of Traditional Chinese Medicine (TCM) on CIN. Cordyceps sinensis (CS), a traditional Chinese herb, has been widely used clinically for the prevention of the progression of renal failu...

متن کامل

Overconsumption of contrast media in percutaneous coronary intervention: Focusing on cost and acute kidney injury

Irrational use of medicines is a major problem worldwide. Since iodixanol (Visipaque®) was categorized in Category I (AV) based on the ABC-VED analysis in our hospital, we evaluated the amount of visipaque use and estimated the incremental cost based on the maximum contrast dose (MCD) following irrational use of contrast media. This retrospective study was conducted on 100 admitted patients age...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Minerva cardioangiologica

دوره 52 5  شماره 

صفحات  -

تاریخ انتشار 2004