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Contrast induced nephropathy

Hirokazu Saito, Kana Noda, Koji Ogasawara, Shutaro Atsuji, Hiroko Takaoka, Hiroo Kajihara, Jiro Nasu, Mitsuhiko Kitaoka, Shoji Morishita, Ikuo Matsushita, Kazuhiro Katahira
Contrast-enhanced computed tomography using iodinated contrast media is useful for diagnosis of gastrointestinal diseases. However, contrast-induced nephropathy remains problematic for kidney diseases patients. Although current guidelines recommended the use of a minimal dose of contrast media necessary to obtain adequate images for diagnosis, obtaining adequate images with sufficient contrast enhancement is difficult with conventional computed tomography using reduced contrast media. Dual-layer spectral detector computed tomography enables the simultaneous acquisition of low- and high-energy data and the reconstruction of virtual monochromatic images ranging from 40 to 200 keV, retrospectively...
April 2018: Radiology Case Reports
Yu-Han Qin, Gao-Liang Yan, Chang-Le Ma, Cheng-Chun Tang, Gen-Shan Ma
In patients undergoing percutaneous coronary intervention after acute myocardial infarction, hyperglycaemia on admission is associated with an increased risk of contrast-induced nephropathy (CIN). However, the effects of hyperglycaemia and elevated glycosylated haemoglobin (HbA1c) on CIN have remained to be fully elucidated. Therefore, a prospective cohort study was performed, comprising 258 patients who underwent coronary angiography between May 2017 and November 2017 at Zhongda Hospital affiliated with Southeast University (Nanjing, China)...
July 2018: Experimental and Therapeutic Medicine
E O Vershinina, A N Repin
OBJECTIVE: The aim of our study was to analyze long-term outcomes, to identify their predictors and to develop a model for determining the risk of long-term adverse сardiovascular events after elective percutaneous coronary interventions (PCI). MATERIALS AND METHODS: A retrospective study included 151 patients 6 years after the elective PCI. Outcomes were assessed by analyzing medical records and telephone interviews. The primary composite end point of the study was a major adverse cardiovascular event (MACCE), including death from cardiovascular causes, acute coronary syndrome, acute cerebrovascular accident...
2018: Kardiologiia
Shiva K Annamalai, Navin K Kapur
Rising urine NGAL and serum creatinine after 48 hr are potentially useful in predicting persistent creatinine increase in patients with contrast-induced AKI. Urinary NGAL may allow for early identification of a high-risk cohort following PCI. Future studies are needed to determine whether renal biomarkers are affected by clinical variables, such as heart failure acute mechanical circulatory support (AMCS) and whether they can be used to identify patients who would benefit from either AMCS reno-protection during PCI remains unknown...
June 2018: Catheterization and Cardiovascular Interventions
Fariba Samadian, Nooshin Dalili, Leila Mahmoudieh, Shadi Ziaei
The administration of radiocontrast media may lead to kidney injury, known as contrast-induced nephropathy, which is reversible in most cases, but its development may be associated with adverse outcomes. This review article provides recommendations for the prevention of contrast nephropathy.
May 2018: Iranian Journal of Kidney Diseases
Manolis S Kallistratos, Leonidas E Poulimenos, Sofia Giannitsi, Pavlos Tsinivizov, Athanasios J Manolis
Trimetazidine (TMZ) is a metabolic agent with significant anti-ischemic properties. By inhibiting the terminal enzyme in the β-oxidation pathway, it shifts the energy substrate metabolism, enhancing glucose metabolism. Thus, it maintains the required energy production with less oxygen consumption, an effect necessary in cases of myocardi. Trimetazidine was recently reaccredited as add-on therapy for symptomatic treatment in patients with stable angina, not adequately controlled or intolerant to first-line therapy...
January 1, 2018: Angiology
Joel Neugarten, Ladan Golestaneh, Nitin V Kolhe
BACKGROUND: Female sex has been included as a risk factor in models developed to predict the risk of acute kidney injury (AKI) associated with cardiac surgery, aminoglycoside nephrotoxicity and contrast-induced nephropathy. The commentary acompanying the Kidney Disease Improving Global Outcomes Clinical Practice Guideline for Acute Kidney Injury concludes that female sex is a shared susceptibility factor for acute kidney injury based on observations that female sex is associated with the development of hospital-acquired acute kidney injury...
June 8, 2018: BMC Nephrology
Maciej T Wybraniec, Jerzy Chudek, Katarzyna Mizia-Stec
INTRODUCTION Contrast‑induced nephropathy is associated with worse prognosis in patients with coronary artery disease (CAD); however, the prognostic role of urinary biomarkers of renal injury has not been fully established. OBJECTIVES We evaluated the clinical utility of urinary biomarkers for the prediction of major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing coronary angiography. PATIENTS AND METHODS This prospective study included 95 consecutive patients with stable and unstable CAD (men, 69...
May 30, 2018: Polish Archives of Internal Medicine
Michael J Ewing, John F Eidt
The incidence of acute kidney injury (AKI) attributed to iodinated contrast has been over-estimated and this has led clinicians to withhold potentially life-saving diagnostic and therapeutic interventions. There is mounting evidence that iodinated contrast plays only a minor role in the development of AKI in comparison with more significant risk factors such as pre-existing renal dysfunction, hemodynamic instability and exposure to nephrotoxic drugs. We will present data which challenge the dogma of avoiding iodinated contrast in patients with reduced renal function...
June 3, 2018: Nephrology, Dialysis, Transplantation
Martin Windpessl, Andreas Kronbichler
The administration of iodinated contrast medium (CM) has immediate negative impact on multiple levels of the nephron, including vasoconstriction, an increase in apoptotic pathways and oxidative stress. Therefore, contrast-induced acute kidney injury (CI-AKI) remains an important cause of sudden impairment of renal function. Far from being just a transient phenomenon, CI-AKI has consistently been shown to be associated with adverse outcomes. The phenomenon of chronic kidney disease (CKD) following AKI might explain why this entity portends a poor prognosis in the long run...
June 3, 2018: Nephrology, Dialysis, Transplantation
E V Vyshlov, V Y Avetisyan, E A Kuzeleva, A A Garganeeva, V A Markov
The aim of this study was to investigate the efficacy and safety of percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction after thrombolytic reperfusion with indirect reperfusion signs. A total of 96 patients aged 75 years and over with acute myocardial infarction and successful thrombolysis (reduction of ST segment elevation 90 min after thrombolysis) were included in this study. Thirty patients (31%) were selected for delayed PCI. Stent implantation was performed in 70% of cases (21 patients)...
2018: Advances in Gerontology, Uspekhi Gerontologii
Denisha Spires, Bibek Poudel, Corbin A Shields, Alyssa Pennington, Brianca Fizer, Lateia Taylor, Kasi C McPherson, Denise C Cornelius, Jan Michael Williams
The endothelin (ET) system has emerged as a therapeutic target for the treatment of diabetic nephropathy (DN). The present study examined whether chronic endothelin A (ETA) receptor blockade with atrasentan prevents the progression of renal injury in two models of DN with pre-existing renal disease that exhibit an increased renal ET-1 system compared to non-diabetic rats: streptozotocin-treated Dahl salt-sensitive (STZ-SS) and Type-2 diabetic nephropathy (T2DN) rats. Nine week-old SS rats were treated with (STZ, 50 mg/kg, i...
May 30, 2018: American Journal of Physiology. Renal Physiology
Hui Fang, Mokan Deng, Linlin Zhang, Aihua Lu, Jiahui Su, Chuanming Xu, Li Zhou, Lei Wang, Jing-Song Ou, Weidong Wang, Tianxin Yang
Proteinuria is not only a common feature of chronic kidney diseases (CKD) but also an independent risk factor promoting CKD progression to end-stage renal failure. However, the underlying molecular mechanisms for protein overload-induced renal injury remain elusive. The present study examined the role of (pro)renin receptor (PRR) in pathogenesis of albumin overload (AO)-induced nephropathy and activation of intrarenal renin-angiotensin system (RAS) in rats. Wistar rats underwent unilateral nephrectomy and were treated for 7 weeks with vehicle, bovine serum albumin (5 g/kg/d via a single i...
May 30, 2018: American Journal of Physiology. Renal Physiology
Eric Matthews
Iodinated contrast agents used in computed tomography (CT) examinations have the potential to cause adverse reactions in patients. The possibility of acute kidney injury should be of concern to radiologic technologists performing CT examinations. Although prevention is paramount, identifying and treating contrast-induced nephropathy, for example, as well as following appropriate guidelines regarding the handling and usage of contrast material, are crucial. This article discusses recent research in these areas...
May 2018: Radiologic Technology
Ling Sun, Xuejun Zhou, Jianguang Jiang, Xuan Zang, Xin Chen, Haiyan Li, Haitao Cao, Qingjie Wang
AIMS: To investigate the association between growth differentiation factor-15 (GDF-15) and contrast-induced nephropathy (CIN) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). METHODS: A total of 311 patients with AMI were studied retrospectively. All patients were divided into two groups according to the occurrence of CIN after PCI. Baseline clinical data were compared between two groups. Multivariate logistic regression analysis was used to identify the risk factors for CIN...
2018: PloS One
Alhasan Mujtaba, Mohammed A Taher, Mazin A Hazza, Hassan M Al-Rubaye, Asaad H Kata, Hamid AbdulWahab, AbdulAmeer AbdulBari, Hayder K AlRubay
INTRODUCTION: Patients undergoing coronary catheterization are at high risk of developing contrast-induced nephropathy (CIN) acute kidney injury (AKI). Several approaches have been supposed to limit such an effect but with mixed results or non-practical methods. Spironolactone is supposed to be effective as a nephroprotective agent in animal studies. This study will try to measure the effect of spironolactone on the incidence of CIN-AKI in patients undergoing coronary catheterization (angiography angioplasty)...
May 21, 2018: Cardiology and Therapy
M Heras Benito, M Garrido Blázquez, Y Gómez Sanz, M Bernardez Mardomingo, J Ruiz Cacho, F J Rodríguez Recio, M J Fernández-Reyes Luis
OBJECTIVE: To analyze the incidence of contrast-induced nephropathy in a cohort of patients undergoing computed tomography (CT) with intravenous iodinated contrast material. To evaluate the efficacy of N-acetylcysteine in preventing contrast-induced nephropathy. PATIENTS AND METHODS: This prospective observational study was carried out in the months comprising March 2016 through July 2016. We selected the first five patients scheduled to undergo CT examination each day who agreed to participate and signed the informed consent form...
May 17, 2018: Radiología
Fei Chen, Fan Liu, Jingchao Lu, Xiuchun Yang, Bing Xiao, Yaqiong Jin, Jie Zhang
BACKGROUND: Contrast-induced nephropathy (CIN) is one of the common hospital-acquired acute renal failures. The purpose of this study was to investigate whether Coenzyme Q10 (CoQ10) and trimetazidine (TMZ) can prevent the occurrence of CIN after elective cardiac catheterization in patients with coronary artery disease complicated with renal dysfunction. METHODS: Consecutive coronary artery disease patients with renal insufficiency scheduled for coronary angiography were enrolled in randomized, paralleled, double-blind, controlled trial...
May 18, 2018: European Journal of Medical Research
Rulian Liang, Qing Zhao, Guihua Jian, Dongsheng Cheng, Niansong Wang, Guangyuan Zhang, Feng Wang
BACKGROUND/AIMS: Tanshinone IIA is a chemical compound extracted from Salvia miltiorrhiza Bunge, a perennial plant also known as red sage used in traditional Chinese medicine. Tanshinone IIA has been shown to protect against various organ injuries. In this study, we hypothesized that Tanshinone IIA could play an anti-oxidative role in contrast-induced nephropathy (CIN) through enhancing Nrf2/ARE activation. METHODS: To test whether Tanshinone IIA can attenuate CIN, oxidative stress, and apoptosis, we utilized two models: an in vivo Sprague-Dawley rat model of ioversol-induced CIN and an in vitro cell model of oxidative stress in which HK2 cells, a human renal tubular cell line, are treated with hydrogen peroxide (H2O2)...
May 7, 2018: Cellular Physiology and Biochemistry
Estelle C Nijssen, Patty J Nelemans, Roger J Rennenberg, Vincent van Ommen, Joachim E Wildberger
OBJECTIVES: Recently, safety guidelines for the use of intravascular iodinated contrast material have been updated, and the recommended threshold for giving prophylaxis to prevent contrast-induced nephropathy (CIN) has been reduced to estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m. Data on this population in the context of CIN, especially evidence for efficacy of the recommendation of prophylactic intravenous hydration, are lacking. The aim of the current study was to test implicit assumptions underlying the guideline update: (1) patients with eGFR <30 mL/min/1...
May 14, 2018: Investigative Radiology
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