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prevention of contrast induced nephropathy

Ling-Yun Liu, Yang Liu, Mei-Yan Wu, Yan-Yan Sun, Fu-Zhe Ma
Background: Results of studies on the efficacy of atorvastatin pretreatment on reducing the prevalence of contrast-induced acute kidney injury (CIAKI) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) have been controversial. Objective: We undertook a meta-analysis to evaluate the efficacy of atorvastatin on contrast-induced nephropathy (CIN) after CAG or PCI. Materials and methods: We undertook a systematic search of electronic databases (PubMed, Embase, and the Cochrane Library) up to June 2017...
2018: Drug Design, Development and Therapy
Mohammad A Hossain, Eric Costanzo, James Cosentino, Chirag Patel, Huzaif Qaisar, Vikas Singh, Taimoor Khan, Jennifer S Cheng, Arif Asif, Tushar J Vachharajani
Contrast-induced acute kidney injury is a common iatrogenic complication associated with increased health resource utilization and adverse outcomes, including short- and long-term mortality and accelerated progression of preexisting renal insufficiency. The incidence of contrast-induced nephropathy (CIN) has been reported to range from 0% to 24%. This wide range reported by the studies is due to differences in definition, background risk factors, type and dose of contrast medium used, and the frequency of other coexisting potential causes of acute renal failure...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
M C Arokiaraj, E Menesson, N Feltin
AIMS: Contrast-induced nephropathy is a commonly encountered problem in clinical practice. The purpose of the study was to design and develop a novel contrast agent, which could be used to prevent contrast-induced nephropathy in the future. METHODS: In total, 20-220nm magnetic nanoparticles were conjugated with iodixanol, and their radio-opacity and magnetic properties were assessed thereafter. Scanning electron microscopy pictures were acquired. Thereafter, the nanoparticles conjugate was tested in cell culture (HUVEC cells), and Quantibody® assay was studied after cell treatment in 1:5 dilutions for 48h, compared with control...
February 2018: Journal de Médecine Vasculaire
Wen-Qi Ma, Yu Zhao, Ying Wang, Xi-Qiong Han, Yi Zhu, Nai-Feng Liu
BACKGROUND: Contrast-induced nephropathy (CIN) is the major complication related to contrast media administration in patients after coronary angiography (CAG). However, inconsistent results have been published in the literature regarding the effects of pharmacological drugs on CIN prevention. We conducted a network meta-analysis to evaluate the relative efficacy of pharmacological interventions for the prevention of CIN. METHODS: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials...
February 5, 2018: International Urology and Nephrology
Leili Iranirad, Mohammad Saleh Sadeghi, Ahmadreza Bagheri, Kobra Doostali, Samieh Norouzi, Seyed Fakhreddin Hejazi, Hossein Saghafi, Sakineh Roshani-Mobaraki
BACKGROUND: Contrast-induced nephropathy (CIN) is considered to be a possibly severe complication of radiography and thus, remains to be the main cause of acute kidney injury (AKI) for inpatients. A clinical trial was executed to measure the preventive effect of allopurinol against CIN in high-risk patients undertaking coronary angiography. METHODS: Through randomized controlled trial, 140 patients with at minimum two risk factors of CIN, undertaking coronary angiography, were randomly allocated to the allopurinol (n = 70) or control group (n = 70)...
September 2017: ARYA Atherosclerosis
Naikuan Fu, Min Liang, Shicheng Yang
The aim of this study is to assess the efficacy of high-dose atorvastatin on the prevention of contrast-induced nephropathy (CIN) in patients with acute coronary syndrome (ACS) undergoing percutaneous intervention and observe the incidence of cystatin C (CyC)-based CIN. A total of 496 patients with ACS were randomly assigned to either the control group (247 patients receiving conventional dose atorvastatin 10 mg daily from 1 day before to 3 days after contrast administration) or the high-dose atorvastatin group (249 patients receiving atorvastatin 40 mg daily for the same perioperative period)...
January 1, 2018: Angiology
Haruki Sekiguchi, Yoichi Ajiro, Yoshie Uchida, Kentaro Jujo, Kazunori Iwade, Naohide Tanaka, Ken Shimamoto, Yukio Tsurumi, Masatoshi Kawana, Nobuhisa Hagiwara
Introduction: Contrast-induced nephropathy is a complication following coronary angiography and percutaneous coronary intervention. Because contrast-induced nephropathy is a predictor of long-term mortality in patients with ischemic heart disease undergoing percutaneous coronary intervention, preventive strategies are required. We assessed the effects of periprocedural oxygenation on contrast-induced nephropathy among patients with pre-existing renal dysfunction. Methods: A total of 200 consecutive patients with impaired renal function (estimated glomerular filtration < 60 ml/min per 1...
January 2018: KI Reports
Sophie De Seigneux, Belen Ponte, Karine Hadaya, Yassine Bouatou, Patrick Saudan
New antidiabetic drugs which slow effectively the course of diabetic nephropathy are now available. There is no benefit of prophylactic hydratation to prevent contrast nephropathy in patients with moderate chronic kidney disease. In elderly hemodialysis patients, hemodiafiltration seems better tolerated than conventional hemodialysis, although there is a similar dialysis-induced myocardial stress with both methods. Role of de novo donor-specific antibodies is better characterized, which may subsequently lead to new treatments of graft rejection...
January 10, 2018: Revue Médicale Suisse
E J Hoorn, R Zietse
In 2007, a national guideline was issued in the Netherlands to prevent contrast-induced nephropathy. This guideline recommended preventive hydration with 0.9% NaCl in patients with reduced estimated glomerular filtration rate (eGFR 30-69 ml/min/1.73 m2) prior to administration of contrast. The recent AMACING study compared hydration versus no hydration, and found that hydration did not prevent contrast-induced nephropathy but did lead to complications and higher costs. The latest 2017 guideline recommends hydration only for patients with eGFR < 30 ml/min/1...
2018: Nederlands Tijdschrift Voor Geneeskunde
E C Nijssen, R J Rennenberg, P J Nelemans, B A Essers, M M Janssen, M A Vermeeren, V van Ommen, J E Wildberger
BACKGROUND: Intravenous saline is recommended in clinical practice guidelines as the cornerstone for preventing contrast-induced nephropathy in patients with compromised renal function. However, clinical-effectiveness and cost-effectiveness of this prophylactic hydration treatment in protecting renal function has not been adequately studied in the population targeted by the guidelines, against a group receiving no prophylaxis. This was the aim of the AMACING trial. METHODS: AMACING is a prospective, randomised, phase 3, parallel-group, open-label, non-inferiority trial of patients at risk of contrast-induced nephropathy according to current guidelines...
2018: Nederlands Tijdschrift Voor Geneeskunde
Xiaofen Ma, Xiang Li, Zhanfeng Jiao, Yiming Zhang
INTRODUCTION: Nicorandil has been suggested as a preventative strategy against the incidence of contrast-induced nephropathy (CIN). However, results of relevant randomized controlled trials (RCTs) were inconsistent. AIMS: We performed a meta-analysis of RCTs to evaluate the preventive efficacy of periprocedural treatment of nicorandil against the incidence of CIN. METHODS: Relevant RCTs were identified via search of PubMed, Embase, and Cochrane's Library databases...
December 28, 2017: Cardiovascular Therapeutics
Rahman Shah, Sarah J Wood, Sajjad A Khan, Amina Chaudhry, M Rehan Khan, Mohamed S Morsy
BACKGROUND: Contrast-induced nephropathy (CIN) is a well-recognized complication of coronary angiography that is associated with poor outcomes. Several small randomized controlled trials (RCTs) have recently shown that in patients with chronic kidney disease (CKD), furosemide-induced forced diuresis with matched hydration using the RenalGuard system can prevent its occurrence. However, individual studies have been underpowered and thus cannot show significant differences in major clinical endpoints...
December 16, 2017: Clinical Cardiology
Si F Sun, Patrick Mk Tang, Min Feng, Xiao Jun, Xiao R Huang, Ping Li, Ronal Cw Ma, Hui Y Lan
TGF-β/Smad signaling plays an important role in diabetic nephropathy. The present study identified a novel Smad3-dependent long non-coding RNA (lncRNA) Erbb4-IR in the development of type-2 diabetic nephropathy (T2DN) in db/db mice. We found that Erbb4-IR was highly expressed in T2DN of db/db mice and was specifically induced by AGE via a Smad3-dependent mechanism. The functional role of Erbb4-IR in T2DN was revealed by kidney-specific silencing of Erbb4-IR to protect against the development of T2DN such as elevated microalbuminuria, serum creatinine and progressive renal fibrosis in db/db mice, and to block AGE-induced collagen I and IV expression in mouse mesangial cells (mMCs) and mouse tubular epithelial cells (mTECs)...
December 8, 2017: Diabetes
Ziliang Ye, Haili Lu, Qiang Su, Xinhua Xian, Lang Li
Objective: Our purpose was to assess the effect of ligustrazine in the prevention of contrast-induced nephropathy (CIN) in patients with unstable angina (UA). Methods: 148 patients with UA undergoing coronary angiography and/or percutaneous coronary intervention (PCI) were selected for observation; the patients were divided into a control group (group A, n=74) and a ligustrazine group (group B, n=74). Group A was given routine treatment, while group B was given routine treatment combined with ligustrazine...
November 3, 2017: Oncotarget
Yub Raj Sedhai, Reshma Golamari, Santosh Timalsina, Soney Basnyat, Ajay Koirala, Ankush Asija, Tatvam Choksi, Akanksha Kushwah, David Geovorgyan, Tawseef Dar, Madhura Borikar, Waseem Ahangar, Joseph Alukal, Subtain Zia, Jose Missri
BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded...
November 2017: American Journal of the Medical Sciences
X Q Suo, S C Yang, Z H Ma, T T Sun, W Y Zhang, H L Cong, W H Lin, C Z Lu, F S Tian, N K Fu
Objective: To investigate the preventive effect, possible mechanism and safety of probucol on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Methods: A total of 641 patients with coronary heart disease were consecutively enrolled from Department of Cardiology, in Tianjin Chest Hospital, Tianjin TEDA International Cardiovascular Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital. They were randomly divided into probucol group (n=321) and control group (n=320)...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Maurizio Sessa, Claudia Rossi, Annamaria Mascolo, Cristina Scavone, Gabriella di Mauro, Roberto Grassi, Liberata Sportiello, Salvatore Cappabianca, Concetta Rafaniello
Background and objective: The use of contrast media in Italy has exponentially increased in the past 3 decades. However, it is unknown whether there has been an increase in clinical research evaluating the risks associated with contrast media usage, especially regarding contrast-induced nephropathy. To fill this gap in knowledge, we performed a systematic review. Study eligibility criteria: Meta-analyses, observational studies, and clinical trials assessing contrast media-induced nephropathy as the safety outcome, in which at least one author was affiliated with an Italian university/health care structure, were eligble...
2017: Therapeutics and Clinical Risk Management
Min Feng, Patrick Ming-Kuen Tang, Xiao-Ru Huang, Si-Fan Sun, Yong-Ke You, Jun Xiao, Lin-Li Lv, An-Ping Xu, Hui-Yao Lan
Transforming growth factor β (TGF-β)/Smad3 signaling plays a role in tissue fibrosis. We report here that Erbb4-IR is a novel long non-coding RNA (lncRNA) responsible for TGF-β/Smad3-mediated renal fibrosis and is a specific therapeutic target for chronic kidney disease. Erbb4-IR was induced by TGF-β1 via a Smad3-dependent mechanism and was highly upregulated in the fibrotic kidney of mouse unilateral ureteral obstructive nephropathy (UUO). Silencing Erbb4-IR blocked TGF-β1-induced collagen I and alpha-smooth muscle actin (α-SMA) expressions in vitro and effectively attenuated renal fibrosis in the UUO kidney by blocking TGF-β/Smad3 signaling...
October 5, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
Shi-Cheng Yang, Nai-Kuan Fu, Jing Zhang, Min Liang, Hong-Liang Cong, Wen-Hua Lin, Feng-Shi Tian, Cheng-Zhi Lu, Ting-Ting Sun, Wen-Ya Zhang, Zhen-Hua Ma
We investigated the preventive effect of alprostadil on contrast-induced nephropathy (CIN) in patients with renal insufficiency undergoing percutaneous coronary intervention (PCI). A total of 300 patients with creatinine clearance (crCl) ≤60 mL/min undergoing PCI were randomly assigned to alprostadil or a control group. The primary end point was the incidence of CIN defined as an increase in serum creatinine (Scr) levels by ≥0.5 mg/dL or≥ 25% after administration of the contrast media within 72 hours...
January 1, 2017: Angiology
Naikuan Fu, Shicheng Yang, Jing Zhang, Peng Zhang, Min Liang, Hongliang Cong, Wenhua Lin, Fengshi Tian, Chengzhi Lu
PURPOSE: To investigate the preventive effect of probucol combined with hydration on contrast-induced nephropathy (CIN) in patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). METHODS: A total of 641 patients undergoing PCI were randomly assigned to either a probucol group (probucol 500 mg twice daily and hydration; n = 321) or a control group (hydration only; n = 320). The primary endpoint was the incidence of CIN, defined as an increase in serum creatinine (Scr) by ≥ 44...
October 25, 2017: International Urology and Nephrology
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