Journal ArticleDOI
Strategies to reduce the risk of contrast-induced nephropathy.
Fulvio Stacul,Andy Adam,Christoph R. Becker,Charles J. Davidson,Norbert Lameire,Peter A. McCullough,James A. Tumlin +6 more
TLDR
The CIN Consensus Working Panel considered that, of the pharmacologic agents that have been evaluated, theophylline, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, ascorbic acid, and prostaglandin E(1) deserve further evaluation.Abstract:
In view of the clinical importance of contrast-induced nephropathy (CIN), numerous potential risk-reduction strategies have been evaluated. Adequate intravenous volume expansion with isotonic crystalloid (1.0-1.5 mL/kg per hr) for 3-12 hours before the procedure and continued for 6-24 hours afterward can lessen the probability of CIN in patients at risk. There are insufficient data on oral fluids (as opposed to intravenous volume expansion) as a CIN-prevention strategy. No adjunctive medical or mechanical treatment has been proved to be efficacious in reducing risk for CIN. Prophylactic hemodialysis and hemofiltration have not been validated as effective strategies. The CIN Consensus Working Panel considered that, of the pharmacologic agents that have been evaluated, theophylline, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), ascorbic acid, and prostaglandin E(1) deserve further evaluation. N-acetylcysteine is not consistently effective in reducing the risk for CIN. Fenoldopam, dopamine, calcium channel blockers, atrial natriuretic peptide, and l-arginine have not been shown to be effective. Use of furosemide, mannitol, or an endothelin receptor antagonist is potentially detrimental. Nephrotoxic drugs should be withdrawn before contrast administration in patients at risk for CIN.read more
Citations
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KDIGO clinical practice guidelines for acute kidney injury.
TL;DR: The guidelines focused on 4 key domains: (1) AKI definition, (2) prevention and treatment of AKI, (3) contrastinduced AKI (CI-AKI) and (4) dialysis interventions for the treatment ofAKI.
Journal ArticleDOI
Editor's Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms.
Anders Wanhainen,Fabio Verzini,Isabelle Van Herzeele,Eric Allaire,Matthew J. Bown,Tina Cohnert,Florian Dick,Joost A. van Herwaarden,Christos D. Karkos,Mark J.W. Koelemay,Tilo Kölbel,Ian M. Loftus,Kevin Mani,Germano Melissano,Janet T. Powell,Zoltán Szeberin,Gert J. de Borst,Nabil Chakfe,Sebastian Debus,Robert J. Hinchliffe,Stavros K. Kakkos,Igor Koncar,Philippe Kolh,Jes S. Lindholt,Melina de Vega,Frank Vermassen,Martin Björck,Stephen W.K. Cheng,Ronald L. Dalman,Lazar Davidovic,Konstantinos P. Donas,J.J. Earnshaw,Hans-Henning Eckstein,Jonathan Golledge,Stéphan Haulon,Tara M. Mastracci,Ross Naylor,Jean-Baptiste Ricco,Hence J.M. Verhagen +38 more
TL;DR: Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms.
Journal ArticleDOI
Contrast-Induced Acute Kidney Injury
TL;DR: The epidemiology, pathophysiology, prognosis, and management of CI-AKI as it applies to the cardiac catheterization laboratory is reviewed.
Journal ArticleDOI
Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines.
Fulvio Stacul,Aart J. van der Molen,Peter Reimer,Judith A. W. Webb,Henrik S. Thomsen,Henrik S. Thomsen,Sameh K. Morcos,Torsten Almén,Peter Aspelin,Marie-France Bellin,Olivier Clément,Gertraud Heinz-Peer +11 more
TL;DR: The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 1999 guidelines on contrast medium-induced nephropathy (CIN) with updated topics covered.
Journal ArticleDOI
NGAL is an early predictive biomarker of contrast-induced nephropathy in children.
Russel Hirsch,Catherine L. Dent,Holly Pfriem,Janene Allen,Robert H. Beekman,Qing Ma,Sudha Dastrala,Michael R. Bennett,Mark Mitsnefes,Prasad Devarajan,Prasad Devarajan +10 more
TL;DR: It is hypothesized that neutrophil gelatinase-associated lipocalin (NGAL) is an early predictive biomarker of contrast-induced nephropathy (CIN), and NGAL concentrations in urine and plasma were found to be powerful independent predictors of CIN.
References
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Journal ArticleDOI
Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine.
TL;DR: Prophylactic oral administration of the antioxidant acetylcysteine, along with hydration, prevents the reduction in renal function induced by contrast agents in patients with chronic renal insufficiency.
Journal ArticleDOI
Effects of Saline, Mannitol, and Furosemide on Acute Decreases in Renal Function Induced by Radiocontrast Agents
TL;DR: In patients with chronic renal insufficiency who are undergoing cardiac angiography, hydration with 0.45 percent saline provides better protection against acute decreases in renal function induced by radiocontrast agents than does hydrationWith 0.
Journal ArticleDOI
Prevention of Contrast-Induced Nephropathy With Sodium Bicarbonate: A Randomized Controlled Trial
Gregory J. Merten,W. Patrick Burgess,Lee V. Gray,Jeremiah H. Holleman,Timothy S. Roush,Glen J. Kowalchuk,Robert M. Bersin,Arl Van Moore,Charles A. Simonton,Robert A. Rittase,H. James Norton,Thomas P. Kennedy +11 more
TL;DR: Hydration with sodium bicarbonate before contrast exposure is more effective than hydration with Sodium chloride for prophylaxis of contrast-induced renal failure.
Journal ArticleDOI
Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty.
Christian Mueller,Gerd Buerkle,Heinz J. Buettner,Jens Petersen,André P. Perruchoud,Urs Eriksson,Stephan Marsch,Helmut Roskamm +7 more
TL;DR: Isotonic hydration is superior to half-isotonicHydration in the prevention of contrast media–associated nephropathy and three predefined subgroups benefited in particular from isotonic hydrations: women, persons with diabetes, and patients receiving 250 mL or more of contrast.
Journal ArticleDOI
The Prevention of Radiocontrast-Agent–Induced Nephropathy by Hemofiltration
Giancarlo Marenzi,Ivana Marana,Gianfranco Lauri,Emilio Assanelli,Marco Grazi,Jeness Campodonico,Daniela Trabattoni,Franco Fabbiocchi,Piero Montorsi,Antonio L. Bartorelli +9 more
TL;DR: In patients with chronic renal failure who are undergoing percutaneous coronary interventions, periprocedural hemofiltration given in an ICU setting appears to be effective in preventing the deterioration of renal function due to contrast-agent-induced nephropathy and is associated with improved in-hospital and long-term outcomes.