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Contrast Induced Nephropathy

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Ibrahim Yildiz, Pinar Ozmen Yildiz, Ibrahim Rencuzogullari, Yavuz Karabag, Metin Cagdas, Cengiz Burak, Mehmet Sait Gurevin
Contrast-induced nephropathy (CIN) is a prevalent and serious complication after primary percutaneous coronary intervention (pPCI). Although the association between serum osmolarity and chronic kidney disease is well established, its relation to CIN in patients with ST-segment elevation myocardial infarction (STEMI) undergoing pPCI needs to be elucidated. We evaluated the predictive value of serum osmolarity for CIN development in patients with STEMI (n = 768) undergoing pPCI. Serum osmolarity on admission was calculated...
February 3, 2019: Angiology
Seung Don Baek, So Mi Kim, Jae-Young Kang, Minkyu Han, Eun Kyoung Lee, Jai Won Chang
Postcontrast acute kidney injury (AKI) occurs more frequently in patients with lower estimated glomerular filtration rate. We hypothesized that postcontrast AKI in chronic kidney disease (CKD) patients with distinct risk factors might be associated with accelerated renal progression.We undertook this retrospective cohort study to develop and validate a risk scoring model for predicting renal progression. In a development dataset, 18,278 contrast-enhanced CT scans were performed in 9097 patients with CKD (estimated glomerular filtration rate [eGFR] < 60 mL/min/1...
February 2019: Medicine (Baltimore)
E Seeliger, P B Persson
Current debate questions the existence of contrast-media-induced acute kidney injury (CIAKI). Once considered the third leading cause for hospital-acquired AKI, CIAKI may be extremely rare, or nonexistent. Retrospective and propensity score-adjusted studies document comparable occurrence of CIAKI, dialysis, and mortality between the groups that received contrast media (CM) intravenously for computed tomography (CT) examinations, and those who underwent non-contrast CT examinations. This article is protected by copyright...
January 28, 2019: Acta Physiologica
Vincent Piller, Patrick Jarlborg, Pierre-Henri Morère
Contrast induced nephropathy has long been considered as the third cause of inpatients acute renal insufficiency after functional renal insufficiency and acute tubular necrosis. This entity is now controversial. Numerous studies failed to show a direct link between intravenous iodinated contrast injection and a worsening of renal function after injected scanners in patients with normal renal function. The notion of contrast induced nephropathy remains integrated in the practice of the majority of physicians, who often overestimate this risk...
January 23, 2019: Revue Médicale Suisse
Satoshi Higuchi, Yusuke Miura, Yoshio Nishina, Kohei Koyama, Ken Kongoji, Kenichi Matsushita, Kyoko Soejima
BACKGROUND: Contrast-induced acute kidney injury is one of the common adverse events related to percutaneous coronary intervention and a predictor for worse outcome. In the setting of percutaneous coronary intervention for chronic total occlusion, large amounts of contrast medium, more than 200-400 mL, are generally injected. A higher dose of contrast medium causes contrast-induced acute kidney injury more frequently. Therefore, patients who undergo chronic total occlusion-percutaneous coronary intervention are at risk for contrast-induced acute kidney injury...
December 27, 2018: Journal of Medical Case Reports
Katarina Leyba, Brent Wagner
PURPOSE OF REVIEW: The hegemony of gadolinium-based contrast agent-induced adverse events stretches beyond those who have renal impairment. 'Nephrogenic' systemic fibrosis is a misnomer: gadolinium-based contrast agents are the known trigger for the disease; kidney impairment is a risk factor. Impaired (true) glomerular filtration may be one catalyst for gadolinium-based contrast agent-induced adverse events, but it is increasingly evident that the same cluster of symptoms occurs in patients with normal renal function...
March 2019: Current Opinion in Nephrology and Hypertension
D Patschan, I Buschmann, O Ritter
Contrast-induced nephropathy (CIN) is a frequent and severe complication in subjects receiving iodinated contrast media for diagnostic or therapeutic purposes. Several preventive strategies were evaluated in the past. Recent clinical studies and meta-analyses delivered some new aspects on preventive measures used in the past and present. We will discuss all pharmacological and nonpharmacological procedures. Finally, we will suggest individualized recommendations for CIN prevention.
2018: International Journal of Nephrology
Yosuke Negishi, Akihito Tanaka, Hideki Ishii, Kensuke Takagi, Yosuke Inoue, Yusuke Uemura, Norio Umemoto, Naoyuki Yoshioka, Itsuro Morishima, Hiroshi Asano, Masato Watarai, Naoki Shibata, Susumu Suzuki, Toyoaki Murohara
The incidence of contrast-induced nephropathy (CIN) increases with the progression of renal dysfunction. Recent reports have shown that percutaneous coronary intervention (PCI) can be safely performed even in patients with advanced renal dysfunction by appropriate CIN-prevention strategies. However, data are limited regarding the occurrence and prognostic influence of CIN in patients with advanced renal dysfunction. We examined the data obtained from 323 consecutive patients with advanced renal dysfunction (eGFR <30 ml/min/1...
February 1, 2019: American Journal of Cardiology
Santiago Garcia, Deepak L Bhatt, Martin Gallagher, Hani Jneid, James Kaufman, Paul M Palevsky, Hongsheng Wu, Steven D Weisbord
OBJECTIVES: The aim of this study was to compare intravenous (IV) sodium bicarbonate with IV sodium chloride and oral acetylcysteine with placebo for the prevention of contrast-associated acute kidney injury (CAAKI) and intermediate-term adverse outcomes. BACKGROUND: Data are conflicting on the optimal strategy to reduce CAAKI and related complications after percutaneous coronary intervention (PCI). METHODS: The PRESERVE (Prevention of Serious Adverse Events Following Angiography) trial used a 2 × 2 factorial design to randomize 5,177 patients with stage III or IV chronic kidney disease undergoing angiography to IV 1...
November 26, 2018: JACC. Cardiovascular Interventions
Naoki Hayakawa, Satoshi Kodera, Noriyoshi Ohki, Syunichi Kushida, Hiroyuki Morita, Junji Kanda, Issei Komuro
A high percentage of patients with critical limb ischemia have concurrent chronic kidney disease (CKD). However, endovascular therapy (EVT) can be problematic in CKD patients. Thus, we developed a method of EVT using digital subtraction angiography (DSA) with diluted contrast medium (low-concentration DSA), wherein DSA parameters were adjusted for diluted contrast angiography (1:10 dilution). Herein, we report the case of an 88-year-old woman with a foot wound and severe CKD. Her estimated glomerular filtration rate was 7...
November 20, 2018: International Heart Journal
Jing Zhang, Ying Guo, Qi Jin, Li Bian, Ping Lin
Background: Contrast-induced nephropathy (CIN) is a complication after the intravascular administration of a contrast medium injection. Previous studies have investigated statins as therapy for CIN due to its positive results in the prevention of contrast-induced acute kidney injury (CI-AKI). Nevertheless, the beneficial effects of rosuvastatin pretreatment in preventing CIN in patients with acute coronary syndromes still remain controversial. In this study, we performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the beneficial impact of rosuvastatin in the prevention of CI-AKI in acute coronary syndrome patients...
2018: Drug Design, Development and Therapy
Asad Ali, Chandur Bhan, Muhammad Bilal Malik, Malik Qistas Ahmad, Shahzad Ahmed Sami
Contrast-induced acute kidney injury, also called contrast-induced nephropathy, is one of the main causes of acute renal failure/acute kidney injury (AKI) in hospitalized patients within 48 to 72 hours of contrast media administration during various radiologic procedures. Several factors can be responsible for contrast-induced acute tubular necrosis (ATN); however, patient and procedure-related factors play the lead role in determining the development of contrast-induced nephropathy. There is no definitive treatment and hydration remains the mainstay preventive strategy...
September 11, 2018: Curēus
Paul Guedeney, Sabato Sorrentino, Birgit Vogel, Usman Baber, Bimmer E Claessen, Roxana Mehran
Chronic kidney disease (CKD) is commonly present in patients undergoing percutaneous coronary intervention (PCI). These patients frequently present with more complex coronary artery disease (CAD) and higher risk of peri-procedural and post-procedural adverse events, including bleeding, thrombotic events, and contrast-induced acute kidney injury (CI-AKI). This article contains updated knowledge and management of patients with CKD undergoing PCI. Areas covered: In this article, the pathophysiological mechanisms behind the association of CKD, complex CAD lesions, and complications of PCI are reviewed and the different risk scores available to assess the occurrence of CI-AKI are detailed...
November 2018: Expert Review of Cardiovascular Therapy
Ziad Al Adas, Kevin Lodewyk, David Robinson, Sherazuddin Qureshi, Loay S Kabbani, Brian Sullivan, Alexander D Shepard, Mitchell R Weaver, Timothy J Nypaver
OBJECTIVE: Contrast-induced nephropathy (CIN) is a frequently used quality outcome marker after peripheral vascular interventions (PVIs). Whereas the factors associated with CIN development have been well documented, the long-term renal effects of CIN after PVI are unknown. This study was undertaken to investigate the long-term (1-year) renal consequences of CIN after PVI and to identify factors associated with renal function deterioration at 1-year follow-up. METHODS: From 2008 to 2015, patients who had PVI at our institution (who were part of a statewide Vascular Interventions Collaborative) were queried for those who developed CIN...
October 3, 2018: Journal of Vascular Surgery
Wuhua Jiang, Jiawei Yu, Jiarui Xu, Bo Shen, Yimei Wang, Zhe Luo, Chunsheng Wang, Xiaoqiang Ding, Jie Teng
BACKGROUND: The association between pre-operative cardiac catheterization and cardiac surgery associated acute kidney injury (CSA-AKI) has been reported inconsistently. The purpose of this study is to evaluate the effect of the catheterization timing and contrast media dose on the incidence of postoperative acute kidney injury. METHODS: Patients who underwent cardiac catheterization and cardiac surgery successively from January 2015 to December 2015 were prospectively enrolled in this study...
October 5, 2018: BMC Cardiovascular Disorders
Laura K Young, Shona Z Matthew, J Graeme Houston
OBJECTIVES: Recent safety concerns regarding gadolinium-based contrast agents (GdCAs) concluded with the suspension of some agents from the European market, yet a clinical consequence remains unknown. We used electronic health records to investigate the incidence of potential toxicity to gadoteric acid (Dotarem®) within our local population, including those with renal insufficiency (RI). METHODS: Data for patients who underwent contrast-enhanced MRI were identified, stratified by renal function at time of scan and retrospectively followed using routinely collected health data...
October 1, 2018: European Radiology
Toshiki Kuno, Yohei Numasawa, Mitsuaki Sawano, Toshiomi Katsuki, Masaki Kodaira, Ikuko Ueda, Masahiro Suzuki, Shigetaka Noma, Koji Negishi, Shiro Ishikawa, Hiroaki Miyata, Keiichi Fukuda, Shun Kohsaka
BACKGROUND: Limiting the contrast volume to creatinine clearance (V/CrCl) ratio is crucial for preventing contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). However, the incidence of CI-AKI and the distribution of V/CrCl ratios may vary according to patient body habitus. OBJECTIVE: We aimed to identify the clinical factors predicting CI-AKI in patients with different body mass indexes (BMIs). METHODS: We evaluated 8782 consecutive patients undergoing PCI and who were registered in a large Japanese database...
2018: PloS One
Deborah Levine, Robert J McDonald, Herbert Y Kressel
No abstract text is available yet for this article.
November 13, 2018: JAMA: the Journal of the American Medical Association
Lorenzo Azzalini, Luz María Vilca, Francesca Lombardo, Enrico Poletti, Alessandra Laricchia, Alessandro Beneduce, Davide Maccagni, Ozan M Demir, Massimo Slavich, Francesco Giannini, Mauro Carlino, Alberto Margonato, Alberto Cappelletti, Antonio Colombo
BACKGROUND: There is controversy as to whether iso-osmolar contrast media (IOCM) are associated with lower risk of contrast-induced acute kidney injury (CI-AKI), compared with low-osmolar contrast media (LOCM). We aimed to evaluate if a differential risk of CI-AKI exists after percutaneous coronary intervention (PCI) according to different contrast media (CM) types. METHODS: We performed a single-center retrospective study in a cohort of all-comers undergoing PCI between January 2012 and December 2016...
September 1, 2018: International Journal of Cardiology
Dadi Helgason, Thorir E Long, Solveig Helgadottir, Runolfur Palsson, Gisli H Sigurdsson, Tomas Gudbjartsson, Olafur S Indridason, Ingibjorg J Gudmundsdottir, Martin I Sigurdsson
BACKGROUND: We studied the incidence and risk factors of acute kidney injury (AKI) following coronary angiography (CA) and examined short- and long-term outcomes of patients who developed AKI, including progression of chronic kidney disease (CKD). METHODS: This was a retrospective study of all patients undergoing CA in Iceland from 2008 to 2015, with or without percutaneous coronary intervention. All procedures were performed with iso-osmolar contrast. AKI was defined according to the SCr component of the KDIGO criteria...
October 2018: Journal of Nephrology
2018-09-08 06:44:54
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