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Contrast nephropathy

Mohamed A Mohamed, Kewan A Hamid
Acute aortic dissection (AAD) classically manifests with sudden, severe chest pain radiating to the back or abdomen, often described as ripping or tearing sensation. Considering its abrupt onset, the diagnosis requires a high index of suspicion prompting immediate imaging using computed tomography (CT) with contrast. However, the use of contrast is a relative contraindication in the patients with renal compromise and acute care physicians are often deterred from contrast use in these patients. Herein, we present an unusual case of hematuria as the presenting symptom of a developing the Stanford type-A AAD...
January 12, 2018: Curēus
Xiaobing Wang, Jin Geng, Hong Zhu, Changying Xing
Many studies have evaluated the renoprotective effect of nicorandil in patients undergoing percutaneous coronary intervention (PCI), but the results are inconsistent. We therefore conducted this meta-analysis to evaluate the protective effect of nicorandil against contrast-induced nephropathy (CIN). We searched PubMed, Embase, the Cochrane Library, Web of Science, and clinical trials database. Studies compared the nicorandil (plus hydration) with hydration alone in patients receiving PCI were eligible. The primary outcome was the incidence of CIN...
February 20, 2018: Oncotarget
Yuan Sheng Tao, Shang Guo Piao, Ying Shun Jin, Ji Zhe Jin, Hai Lan Zheng, Hai Yan Zhao, Sun Woo Lim, Chul Woo Yang, Can Li
BACKGROUND: Accumulating evidence suggests that a decrease in brain-derived neurotrophic factor (BDNF) level induces a variety of psychiatric and neurological disorders. However, the expression and role of BDNF in the kidney have not been explored. The present study examined the expression of BDNF and tropomyosin-related kinase (Trk) receptors in an experimental model of chronic cyclosporine A (CsA) nephropathy. METHODS: Sprague-Dawley rats on a salt-deplete diet were treated daily for four weeks with vehicle or CsA...
March 14, 2018: BMC Nephrology
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
Angela Atinga, Andreas Shekkeris, Michael Fertleman, Nicola Batrick, Elika Kashef, Elizabeth Dick
Major Trauma Centres and Emergency Departments are treating an increasing number of geriatric trauma patients in the UK. Elderly patients, generally defined as those over the age of 65 years, are more susceptible to injury from lesser mechanisms of trauma than younger adults. The number of geriatric trauma cases is rising yearly, accounting for > 25% of all major trauma cases nationally. The elderly have different physiological reserves and a different response to trauma, due to premorbid frailty, co-existing conditions and prescribed medication...
March 6, 2018: British Journal of Radiology
Naro Ohashi, Shinsuke Isobe, Takashi Matsuyama, Sayaka Ishigaki, Naoko Tsuji, Tomoyuki Fujikura, Takayuki Tsuji, Akihiko Kato, Hideo Yasuda
Intrarenal renin-angiotensin system (RAS) activation plays an important role in the development of hypertension and renal damage. However, the association between daytime and night-time intrarenal RAS activation and renal structural damage in normotensive IgA nephropathy patients is unclear. We investigated the relationships between urinary angiotensinogen (U-AGT) excretion, which reflects intrarenal RAS activity, and renal structural damage (i.e., endocapillary and mesangial cell hypercellularity, arteriolar hyalinosis and arteriosclerosis levels, and global glomerulosclerosis and tubulointerstitial fibrosis percentages) in 27 normotensive IgA nephropathy patients (age 39...
March 5, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Damiano Regazzoli, Daisuke Hachinohe, Ozan M Demir, Mauro Carlino, Julien Lemoine, Satoru Mitomo, Enrico Poletti, Max Amor, Antonio Colombo, Lorenzo Azzalini
Candidates for percutaneous coronary revascularization are becoming progressively older and more complex. A combination of factors related to the patient, lesion, and/or hemodynamic conditions may increase the risk of adverse events. Therefore, when a high-risk procedure is identified, it is crucial to provide the patient with adequate support in order to safely perform percutaneous coronary intervention (PCI). We report the case of a 77-year-old man with moderate left ventricular dysfunction and stage IV chronic kidney disease who underwent successful recanalization of a chronically occluded left anterior descending artery...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Claudio Moretti, Enrico Cerrato, Erika Cavallero, Song Lin, Marco Luciano Rossi, Andrea Picchi, Francesca Sanguineti, Fabrizio Ugo, Alberto Palazzuoli, Maurizio Bertaina, Patrizia Presbitero, Chen Shao-Liang, Roberto Pozzi, Massimo Giammaria, Ugo Limbruno, Thierry Lefèvre, Valeria Gasparetto, Roberto Garbo, Pierluigi Omedè, Imad Sheiban, Javier Escaned, Giuseppe Biondi-Zoccai, Fiorenzo Gaita, Leor Perl, Fabrizio D'Ascenzo
BACKGROUND: The potential protective effects of remote ischemic preconditioning (RIPC) on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) remain to be defined. METHODS AND RESULTS: A double blind, randomized, placebo controlled multicenter study was performed. Patients younger than 85years old, with a renal clearance of 30-60ml/min/1.73m2 , who were candidates for PCI for all clinical indications except for primary PCI, were allocated 1:1 to RIPC or to standard therapy...
April 15, 2018: International Journal of Cardiology
Taner Ulus, Kamal Isgandarov, Ahmet Serdar Yilmaz, Samet Uysal, Ibrahim Vasi, Muhammet Dural, Fezan Mutlu
Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with acute coronary syndrome (ACS). Early identification and intervention for patients with a high risk of CIN are very important to improve clinical outcomes. Inflammation plays important role in the development of CIN in the setting of ACS. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. Bleeding is also associated with worse prognosis in such patients. We aimed to investigate whether the preprocedural MHR had a predictive role for CIN development in such patients...
January 1, 2018: Angiology
Nicole Endlich, Felix Kliewe, Frances Kindt, Katharina Schmidt, Ahmed M Kotb, Nadine Artelt, Maja T Lindenmeyer, Clemens D Cohen, Franziska Döring, Andreas W Kuss, Kerstin Amann, Marcus J Moeller, Nazanin Kabgani, Antje Blumenthal, Karlhans Endlich
Dedifferentiation and loss of podocytes are the major cause of chronic kidney disease. Dach1, a transcription factor that is essential for cell fate, was found in genome-wide association studies to be associated with the glomerular filtration rate. We found that podocytes express high levels of Dach1 in vivo and to a much lower extent in vitro. Parietal epithelial cells (PECs) that are still under debate to be a type of progenitor cell for podocytes expressed Dach1 only at low levels. The transfection of PECs with a plasmid encoding for Dach1 induced the expression of synaptopodin, a podocyte-specific protein, demonstrated by immunocytochemistry and Western blot...
March 2, 2018: Journal of Cellular and Molecular Medicine
Jae Kim, Shailesh Male, Bharathi D Jagadeesan, Christopher Streib, Ramachandra P Tummala
PURPOSE: Contrast-induced nephropathy is a common clinical concern in patients undergoing neuroendovascular procedures, especially in those with pre-existent kidney disease. We aimed to define the incidence of contrast-induced nephropathy in these high-risk patients in our practice. METHODS: We analyzed data retrospectively from patients undergoing neuroendovascular procedures at two academic medical centers over a 4-year period. Contrast-induced nephropathy was determined by an absolute increase in serum creatinine of 0...
March 1, 2018: Neuroradiology
XingMei Liu, YingYing Zhang, MingJun Shi, YuanYuan Wang, Fan Zhang, Rui Yan, LingLing Liu, Ying Xiao, Bing Guo
Diabetic nephropathy (DN) is a serious clinical microvascular complication of diabetes mellitus. DN is characterized by the accumulation of extracellular matrix, resulting in progressive fibrosis leading to the loss of renal function. Notch1 and phosphatase and tensin homolog deleted on chromosome ten (PTEN) signaling have been associated with fibrosis. Autophagy serves as an essential regulator of tubular cellular homeostasis. However, how these molecules control the balance between fibrosis and autophagy, the main homeostatic mechanism regulating fibrosis, is not well understood...
February 26, 2018: Biochemical and Biophysical Research Communications
Fazhan Zhou, Wei Song, Zilong Wang, Luhua Yin, Shen Yang, Fubai Yang, Zhaofeng Song, Yaguang Song, Huanyi Zhang, Fengjie Qiao, Zhimian Zhang
OBJECTIVE: The aim of this study was to explore the clinical effects of remote ischemic preconditioning (RIPC) on contrast-induced nephropathy after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). PATIENTS AND METHODS: The study was a single-center, prospective, randomized, controlled study. A total of 161 patients with ACS and the rate of estimate glomerular filtration (eGFR) 15 to 70 mL/min/1.73 m2 undergoing PCI were randomly assigned to RIPC group (induced by 4 times of 5-minute inflations of a blood pressure cuff to 200 mmHg around the upper arm, followed by 5-min intervals of reperfusion at 1 hour before PCI therapy) or control group (an uninflated cuff around the arm)...
January 2018: Medicine (Baltimore)
Jai-Sing Yang, Yan-Ru Peng, Shih-Chang Tsai, Yeu-Sheng Tyan, Chi-Cheng Lu, Hong-Yi Chiu, Yu-Jen Chiu, Sheng-Chu Kuo, Yuh-Feng Tsai, Ping-Chin Lin, Fuu-Jen Tsai
Iodinated contrast media (iodinated CM) have increased ability to absorb x-rays and to visualize structures that normally are impossible to observe in a radiological examination. The use of iodinated CM may destory renal function, commonly known as contrast-induced nephropathy (CIN), which can result in acute renal failure (ARF). This review article mainly focuses on the following areas: (1) classifications of iodinated CM: ionic or non-ionic, high-osmolarity contrast media (HOCM), low-osmolarity contrast media (LOCM) and iso-osmolarity contrast media (IOCM); (2) an introduction to the physical and chemical properties of the non-ionic iodinated CM; (3) the management of anaphylactic reaction by iodinated CM; (4) a suggested single injection of adult doses and maximum dose for non-ionic iodinated CM; (5) the molecular mechanism of contrast-induced nephropathy (CIN); (6) In vitro studies on iodinated CM...
March 2018: BioMedicine
Lorenzo Azzalini, Satoru Mitomo, Daisuke Hachinohe, Damiano Regazzoli, Antonio Colombo
Individuals with advanced chronic kidney disease (CKD) and coronary artery disease are often denied percutaneous coronary intervention (PCI) because of an aversion to the risk of contrast-induced nephropathy. We present the case of a 76-year-old man with stage 4 CKD requiring coronary revascularization. Zero-contrast PCI was successfully performed using dextran-based optical coherence tomography (OCT) guidance. Our report suggests the feasibility of dextran-based, OCT-guided, zero-contrast PCI in patients with advanced CKD...
March 2018: Canadian Journal of Cardiology
Yasunori Nagayama, Shota Tanoue, Akinori Tsuji, Joji Urata, Mitsuhiro Furusawa, Seitaro Oda, Takeshi Nakaura, Daisuke Utsunomiya, Eri Yoshida, Morikatsu Yoshida, Masafumi Kidoh, Machiko Tateishi, Yasuyuki Yamashita
OBJECTIVE: To evaluate the image quality, radiation dose, and renal safety of contrast medium (CM)-reduced abdominal-pelvic CT combining 80-kVp and sinogram-affirmed iterative reconstruction (SAFIRE) in patients with renal dysfunction for oncological assessment. METHODS: We included 45 patients with renal dysfunction (estimated glomerular filtration rate [eGFR] <45 mL/min/1.73m2) who underwent reduced-CM abdominal-pelvic CT (360 mgI/kg, 80-kVp, SAFIRE) for oncological assessment...
February 22, 2018: British Journal of Radiology
Rui Wu, Yiwei Kong, Jianyong Yin, Rulian Liang, Zeyuan Lu, Niansong Wang, Qing Zhao, Yang Zhou, Chungen Yan, Feng Wang, Mingyu Liang
BACKGROUND/AIMS: Antithrombin Ⅲ (AT Ⅲ) is an important endogenous anticoagulant and has strong anti-inflammatory properties. Low ATⅢ activity is considered to be a predictor of poor outcomes in several conditions, including acute kidney injury after cardiac surgery. However, the association between the ATⅢ level and the occurrence of contrast induced nephropathy (CIN) has not been elucidated. In this study, our aim was to identify the potential predictive value of ATⅢ for CIN...
February 16, 2018: Kidney & Blood Pressure Research
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
Tarun Jain, Sunay Shah, Jainil Shah, Gordon Jacobsen, Akshay Khandelwal
INTRODUCTION: Contrast-induced nephropathy (CIN) following percutaneous coronary intervention (PCI) is associated with adverse outcomes; however, there are scarce data comparing clinical outcomes of post-PCI CIN in ST elevation myocardial infarction (STEMI) patients with and without chronic kidney disease (CKD). We sought to assess the incidence, clinical predictors, and short-term and long-term clinical outcomes of post-PCI CIN in STEMI patients with and without CKD. METHODS: We performed a retrospective observational cohort study involving 554 patients who underwent PCI for STEMI from February 2010 to November 2013...
March 2018: Critical Pathways in Cardiology
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
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