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prevention of contrast induced nephropathy

Y-F Huang, Y Zhang, C-X Liu, J Huang, G-H Ding
OBJECTIVE: Hyperglycemia induces apoptosis of renal tubular epithelial cells and contributes to tubular injury in diabetic nephropathy. Angiotensin-converting enzyme 2 (ACE2) is known to protect against diabetic kidney injury. However, the mechanism for the dysregulation of ACE2 expression in diabetic nephropathy is unclear. MATERIALS AND METHODS: Bioinformatic analysis and luciferase reporter assay were done to identify ACE2-targeting microRNAs. Gain- and loss-of-function experiments were performed to determine the biological roles of the ACE2-targeting microRNAs in high glucose-induced damage to renal tubular epithelial cells...
October 2016: European Review for Medical and Pharmacological Sciences
Debabrata Dash
Despite the continuing developments of improved medical devices and increasing operator expertize, coronary chronic total occlusion (CTO) remains as one of the most challenging lesion subsets in interventional cardiology. Percutaneous coronary intervention (PCI) of CTO is a complex procedure carrying the risk of complications that are responsible for significant morbidity and mortality. The complications can be classified as coronary (such as coronary occlusion, perforation, device embolization, or entrapment); cardiac non-coronary (such as periprocedural myocardial infarction); extra cardiac (such as vascular access complications, systemic embolization, contrast-induced nephropathy, and radiation-induced injury)...
September 2016: Indian Heart Journal
Farzanehsadat Minoo, Mahboob Lessan-Pezeshki, Ata Firouzi, Salman Nikfarjam, Seyed Mansoor Gatmiri, Elham Ramezanzade
INTRODUCTION: The aim of the study was to investigate the efficacy of nasal oxygen as a supplementation to hydration therapy in reducing the risk of developing contrast-induced nephropathy (CIN). MATERIALS AND METHODS: In a randomized controlled trial, 348 patients scheduled to undergo elective coronary angiography were randomly allocated to standard hydration plus 2 L/min to 3 L/min nasal oxygen (from 10 minutes before the procedure until the end of the procedure) (n = 176) or standard hydration alone (n = 176)...
September 2016: Iranian Journal of Kidney Diseases
Xue-Biao Wei, Lei Jiang, Xin-Rong Liu, Dan-Qing Yu, Ning Tan, Ji-Yan Chen, Ying-Ling Zhou, Peng-Cheng He, Yuan-Hui Liu
PURPOSE: Contrast-induced nephropathy (CIN) is a serious complication and associated with poor clinical outcomes. The protective value of brain natriuretic peptide (BNP) administration on CIN is still controversial in patients undergoing percutaneous coronary intervention (PCI) or coronary angiography (CAG). We performed a meta-analysis of randomized controlled trials (RCTs) for BNP in preventing CIN. METHODS: We systematically searched PubMed, Web of Science, Cochrane Library, and ClinicalTrials...
November 2016: European Journal of Clinical Pharmacology
Renfan Xu, Anyu Tao, Yang Bai, Youbin Deng, Guangzhi Chen
BACKGROUND: Conflicting results have been obtained in trials that have evaluated the prophylactic efficacy of N-acetylcysteine (NAC) pretreatment in the prevention of contrast-induced nephropathy (CIN). In this meta-analysis of randomized controlled trials, we aimed to assess the effectiveness of NAC treatment for the prevention of CIN. METHODS AND RESULTS: PubMed, EMBASE, and the Cochrane Library were electronically searched from inception to January 2016 for all relevant studies...
2016: Journal of the American Heart Association
Arezoo Khosravi, Mitra Dolatkhah, Hesam Sadat Hashemi, Zohreh Rostami
BACKGROUND: Contrast-induced nephropathy (CIN) is one of the most important complications of angiography in patients with chronic kidney disease (CKD) or diabetes mellitus. The prevention of CIN can decrease therapeutic costs and hospital stays. There is controversy in the literature over the preventive effect of statins on CIN. OBJECTIVES: This study was designed to evaluate the preventive effect of atorvastatin on CIN after angiography in CKD and diabetic patients...
May 2016: Nephro-urology Monthly
G T C Wong, E Y P Lee, M G Irwin
Contrast induced nephropathy (CIN) is traditionally associated with outpatient imaging studies. More recently, patients afflicted with vascular pathologies are increasingly undergoing endovascular treatments that require the use of iodinated contrast media (CM) agents, thus placing them as risk of developing CIN. As perioperative physicians, anaesthetists should be aware of the risk factors and measures that might minimize acute kidney injury caused by CM. This review evaluates recent data regarding preventive measures against CIN and where possible, places the evidence in the context of the patient receiving endovascular surgical treatment...
September 2016: British Journal of Anaesthesia
Sadegh Ali-Hassan-Sayegh, Seyed Jalil Mirhosseini, Zahra Ghodratipour, Zahra Sarrafan-Chaharsoughi, Elham Rahimizadeh, Ali Akbar Karimi-Bondarabadi, Fatemeh Haddad, Arezoo Shahidzadeh, Parisa Mahdavi, Ali-Mohammad Dehghan, Mahbube Tahernejad, Azadeh Shahidzadeh, Hamidreza Dehghan, Azam Ghanei, Mohammadreza Lotfaliani, Alexander Weymann, Mohamed Zeriouh, Aron-Frederik Popov, Anton Sabashnikov
This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations (N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics, and angiotensin-converting enzyme inhibitors [ACEIs]) on the incidence of contrast-induced nephropathy (CIN) and requirement for hemodialysis after coronary angiography. After screening, a total of 125 trials that reported outcomes were identified...
August 1, 2016: Angiology
Yoshito Yamaguchi, Masashi Morita, Akira Mega, Ryota Haga, Ikue Nagayama, Yu Yamanouchi, Tatsufumi Oka, Katsuyuki Nagatoya, Atsushi Yamauchi
BACKGROUND: In Japan, "Guidelines for iodinated contrast in a patient with chronic kidney disease (CKD) 2012" was published, but preventive protocols for specific contrast-induced nephropathy (CIN) have not been specified. Therefore, we developed a CIN preventive protocol, and validated its operation and renal protective effect. METHODS: In a retrospective cohort study, we determined eGFR within 3 months before contrast-enhanced computed tomography (CECT). We evaluated CKD stage 3b - 4 adult patients (eGFR 15 - 45 mL/min/1...
2016: Nihon Jinzo Gakkai Shi
Suleyman Turedi, Erkan Erdem, Yunus Karaca, Ozgur Tatli, Aynur Sahin, Suha Turkmen, Abdulkadir Gunduz
STUDY OBJECTIVE: To compare the protective effects of N-acetylcysteine (NAC) plus normal saline (NS), sodium bicarbonate (NaHCO3) plus NS and NS alone in the prevention of contrast-induced nephropathy (CIN) after computed tomography pulmonary angiography (CTPA) in emergency patients. MATERIALS AND METHODS: This study was planned as a randomized, controlled clinical research. Patients undergoing contrast-enhanced CTPA on suspicion of pulmonary embolism (PE) in the emergency department and with at least one risk factor for development of CIN were included in one of three different prophylaxis groups...
July 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shi-Jie Zhao, Zhao-Shuang Zhong, Guo-Xian Qi, Wen Tian
BACKGROUND: The efficacy of combining use of N-acetylcysteine (NAC) and sodium bicarbonate (SOB) in the prevention of contrast-induced nephropathy (CIN) after cardiac catheterization and percutaneous coronary intervention (PCI) is unclear. METHODS: All relevant studies that compared the effect of combining the use of NAC and SOB with individual use on CIN in patients undergoing cardiac catheterization and PCI were identified by searching the databases including Pubmed, Embase, Cochrane Library, and Web of Science without time and language limitation...
October 15, 2016: International Journal of Cardiology
Feng Wang, Jianyong Yin, Zeyuan Lu, Guangyuan Zhang, Junhui Li, Tao Xing, Shougang Zhuang, Niansong Wang
Clinical trials shows that remote ischemic preconditioning (IPC) can protect against contrast induced nephropathy (CIN) in risky patients, however, the exact mechanism is unclear. In this study, we explored whether renalase, an amine oxidase that has been previously shown to mediate reno-protection by local IPC, would also mediate the same effect elicited by remote IPC in animal model. Limb IPC was performed for 24h followed by induction of CIN. Our results indicated that limb IPC prevented renal function decline, attenuated tubular damage and reduced oxidative stress and inflammation in the kidney...
July 2016: EBioMedicine
Yi Wei Wu, Kheng Song Leow, Yujin Zhu, Cher Heng Tan
Iodinated radiocontrast media (IRCM) is widely used in current clinical practice. Although IRCM is generally safe, serious adverse drug reactions (ADRs) may still occur. IRCM-induced ADRs may be subdivided into chemotoxic and hypersensitivity reactions. Several factors have been shown to be associated with an increased risk of ADRs, including previous contrast media reactions, history of asthma and allergic disease, etc. Contrast media with lower osmolality is generally recommended for at-risk patients to prevent ADRs...
April 2016: Annals of the Academy of Medicine, Singapore
Chung-You Tsai, Shi-Heng Wang, Min-Huei Hsu, Yu-Chuan Jack Li
OBJECTIVES: False positive alerts in patient-safety-related clinical decision support systems (CDSS) are defined as alerts which incorrectly prompt when no-risk patients are encountered. It is an unfavorable condition which may potentially mislead physicians. The aim is to investigate physician responses toward false positive (FP) and true positive (TP) alerts in CDSS for the prevention of contrast-induced nephropathy (CIN). METHODS: A two-arm cluster randomized controlled trial was conducted in university hospitals...
August 2016: Computer Methods and Programs in Biomedicine
Wolfgang Huber, Toni Huber, Stephan Baum, Michael Franzen, Christian Schmidt, Thomas Stadlbauer, Analena Beitz, Roland M Schmid, Sebastian Schmid
In this study, we investigated whether hydration with sodium bicarbonate is superior to hydration with saline in addition to theophylline (both groups) in the prophylaxis of contrast-induced nephropathy (CIN). It was a prospective, randomized, double-blinded study in a university hospital on 2 general intensive care units (63% of investigations) and normal wards.After approval of the local ethics committee and informed consent 152 patients with screening serum creatinine ≥1.1 mg/dL and/or at least 1 additional risk factor for CIN undergoing intravascular contrast media (CM) exposure were randomized to receive a total of 9 mL/kg bicarbonate 154 mmol/L (group B; n = 74) or saline 0...
May 2016: Medicine (Baltimore)
Sameh Mohamed Abouzeid, Hossam E ElHossary
Contrast-induced nephropathy (CIN) is one of the important complications of radiographic procedures, especially in patients with chronic kidney disease. It is also one of the common causes of acute kidney injury. The pathogenesis is postulated to be the effect of oxygen- free radicals and hyperosmolar stress on the renal medulla. It is reported that the production of superoxide is most active at acid environment. K/Na citrate is well known as a urine alkalinization medium, and this has been evaluated earlier with standard hydration for reduction of CIN and was stated to be efficient...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
Shiju Zhou, Chaoran Wu, Qingyin Song, Xu Yang, Zixiu Wei
AIMS: The purpose of this study was to evaluate the effect of angiotensin-converting enzyme inhibitors (ACEIs) on contrast-induced nephropathy (CIN) in patients undergoing coronary angiography or percutaneous coronary intervention (PCI). METHODS: We searched the Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP database and Wanfang database up to December 2014. Pooled risk ratios (RRs) or weighted mean difference (WMD) with their 95% CIs for the CIN incidence, serum creatinine (SCr), estimated glomerular filtration rate (eGFR) and blood urea nitrogen (BUN) of the patients were collected and calculated using the software Review Manager 5...
2016: Nephron
Hossein Nough, Roya Daryachahei, Leila Hadiani, Mohammad Reza Najarzadegan, Masoud Mirzaee, Roya Hemayati, Mahdy Meidani, Roya Mousazadeh, Seyedhmahdyeh Namayandeh
BACKGROUND: This study aims to investigate the antioxidant effect of vitamin C in preventing contrast-induced nephropathy (CIN) in diabetic patients after catheterization. MATERIALS AND METHODS: In a double blinded, randomized controlled trial, 90 diabetic patients who were referred for cardiac catheterization were randomly allocated into two arms of vitamin C (A) and placebo (B). The treatment arm (A) received 2 g of vitamin C orally 2 h before catheterization and the control group (B) received 2 g of oral placebo...
2016: Advanced Biomedical Research
Nagaraju Sarabu, Mahboob Rahman
Acute kidney injury (AKI) refers to any acute decrease in glomerular filtration rate, regardless of etiology. Staging of AKI has been recommended to stratify AKI patients according to severity of the condition, based on serum creatinine level and urine output. Classification of AKI into prerenal, intrinsic renal, and postrenal etiologies is helpful in differential diagnosis and management. AKI in hospitalized patients typically occurs due to decreased renal perfusion. Drug-induced, contrast-associated, postoperative, and sepsis-associated AKI also can occur...
May 2016: FP Essentials
Sameh Abouzeid, Osama Mosbah
INTRODUCTION: The rapid decline in renal function caused by radiographic contrast agents usually is transient, but it can result in chronic kidney disease. The pathophysiology of contrast-induced nephropathy (CIN) is poorly understood, but it may include acute hypoxia-induced oxidative stress and free radicals generated within the acid environment of the renal medulla. Thus, the alkalization of urine by sodium bicarbonate has been regarded as resulting in the reduction of CIN. The aim of this study was to determine whether a long-duration sodium bicarbonate regimen is more effective than a short-duration regimen in reducing CIN...
February 2016: Electronic Physician
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