Contrast induced nephropathy

Lameier NH. Contrast-induced nephropathy—prevention and risk reduction. Nephrol... 

Therapeutic measures that have been used to decrease the incidence of contrast-induced nephropathy include extracellular volume expansion, minimization of the amount of contrast administered, and treatment with oral acetylcysteine. Theophylline, fenoldopam, loop diuretics, mannitol, dopamine, and calcium antagonists have no effect or may worsen ARF. 

The most common therapeutic maneuver to decrease the incidence of contrast-induced nephropathy is extracellular volume expansion.36 Several recent studies have compared the efficacy of isotonic sodium chloride (0.9%) to half normal... 

M. Tepel, P. Aspelin, N. Lameire, Contrast-induced nephropathy A clinical and evidence-based approach. Circulation 113 (2006) 1799-1806. 

Contrast-induced nephropathy has been defined as an increase in serum creatinine of at least 25% or an absolute increase in serum creatinine of at least 0.5 mg/dL within 48 to 72 hours of iodinated contrast administration and is associated with significant morbidity and mortality (75). Important risk factors include diabetes mellitus, chronic renal insufficiency, administration of large volumes of high osmolar contrast agents, and intravascular volume depletion. Numerous pharmacologic preventive measures have been studied, but consistent benefits have not been demonstrated. In a recent large retrospective study, preprocedural statin therapy was independently associated with a lower risk of contrast nephropathy and nephropathy requiring dialysis (76). 

Khanal S, Attallah N, Smith DE, et al, Statin therapy reduces contrast-induced nephropathy an analysis of contemporary percutaneous interventions, The potential role of statins in contrast nephropathy, Am J Med 2005 I I 8 843-849. 

Contrast-induced nephropathy (CIN), defined as a serum creatinine increase of >25% relative to baseline, is associated... 

Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention development and initial validation. J Am Coll Cardiol 2004 44 1393-1399. 

Merten GJ, Burgess WR Gray LY et al, Prevention of contrast-induced nephropathy with sodium bicarbonate a randomized controlled trial. JAMA 2004 291 2328-2334. 

Contrast-induced nephropathy after percutaneous coronary interventions... 

Contrast-induced nephropathy (CIN) is the most serious complication associated with the use of CM and can negatively affect long-term patient morbidity and mortality (4-10). CIN is usually defined as an acute decline in renal function characterized by an absolute rise of 0.5mg/dl (44jumol/l) in serum creatinine (SCr) or a 25% increase from baseline, occurring after the systemic administration of CM in the absence of other risk factors such as atheroembolic disease, hypotension and lew blood volume, surgery, or nephrotoxins (1,2,6,7,10-13). 

Osmolality of contrast media and contrast-induced nephropathy... 

The prognostic significance of the proposed risk score for CIN extended to prediction of one-year mortality, as indicated by the results obtained from both the development and validation datasets. (Solid bars) development dataset (open bars) validation dataset Abbreviations CIN, contrast-induced nephropathy CKD, chronic kidney disease. Source From Refs. 7, 13. 

One-year survival after percutaneous coronary intervention in patients with or without chronic kidney disease and with or without contrast-induced nephropathy. Source From Ref, 7,... 

McCullough R Outcomes of contrast-induced nephropathy experience in patients undergoing cardiovascular intervention. Catheter Cardiovasc Interv 2006 67 335-343. 

McCullough PA, Soman SS. Contrast-induced nephropathy. Crit Care Clin 2005 21 261 -280. 

Bagshaw SM, Culleton BE Contrast-induced nephropathy epidemiology and prevention. Minerva Cardioangiol 2006 54 109-129. 

Dangas G, lakovou I, Nikolsky E, et al. Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. Am J Cardiol 2005 95 13-19. 

Sanaei-Ardekani M, Movahed MR, Movafagh S, et al, Contrast-induced nephropathy a review, Cardiovasc Revasc Med 2005 6 82-88. 

Rudnick MR, Kesselheim A, Goldfarb S. Contrast-induced nephropathy how it develops, howto prevent it. Cleve Clin J Med 2006 73 75-80, 83-87. 

Aspelin P Aubry R Fransson SG, et al. Cost-effectiveness of iodixanol in patients at high risk of contrast-induced nephropathy. Am Heart J 2005 149 298-303. 

Heinrich M, Uder M. Pathogenesis of contrast-induced nephropathy. AJR Am J Roentgenol 2005 185 1079 author reply 1079. 

Marenzi G, Lauri G, Assanelli E, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 2004 44 1780-1785. 

Boccalandro E Anderson HV Contrast-induced nephropathy back to basics. J Invasive Cardiol 2003 15 3 17-3 18. 

Bagshaw SM, McAlister FA, Manns BJ, et al. Acetylcysteine in the prevention of contrast-induced nephropathy a case study of the pitfalls in the evolution of evidence. Arch Intern Med 2006 166 161-166. 

Stone GW, McCullough PA, Tumlin JA, et al. Fenoldopam mesylate for the prevention of contrast-induced nephropathy a randomized controlled trial. JAMA 2003 290 2284-2291. 

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