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contrast kidney injury

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
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
Ling Sun, Xuejun Zhou, Jianguang Jiang, Xuan Zang, Xin Chen, Haiyan Li, Haitao Cao, Qingjie Wang
BACKGROUND: Growth differentiation factor-15 (GDF-15) is an emerging biomarker for risk stratification in cardiovascular disease. Contrast-induced acute kidney injury (AKI) is an important complication in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). In this retrospectively observational study, we aimed to determine the role of GDF-15 and the risk of AKI in acute myocardial infarction (AMI) patients. METHODS: The medical records of 1195 patients with AMI were reviewed...
2018: PloS One
Luigi Di Serafino, Maurizio Turturo, Saverio Lanzone, Melissa Marano, Gabriella Scognamiglio, Bruno Trimarco, Plinio Cirillo, Giovanni Esposito, Carlo D'Agostino
Dual-axis rotational coronary angiography (DARCA) has already been shown to reduce both the amount of contrast medium and radiation exposure compared with conventional coronary angiography (CCA). However, a clinical benefit of such imaging modality has never been demonstrated. The aim of this study was to evaluate the efficacy of DARCA to prevent acute kidney injury (AKI) compared with CCA. Consecutive patients who underwent coronary angiography were enrolled to DARCA (n = 80) or CCA (n = 80). Patients presenting with ST-segment elevation myocardial infarction or previously underwent coronary artery bypass graft were excluded...
February 7, 2018: American Journal of Cardiology
Li Ning, Zhiguo Li, Dianjun Wei, Haiyan Chen, Chao Yang, Dawei Wu, Yanchun Wang, Jingwei Zhang
Contrast-induced acute kidney injury (CI-AKI) is a serious complication of diagnostic coronary angiograph and percutaneous coronary intervention (PCI). However, the exact pathophysiological mechanisms underlying CI-AKI development are largely unknown. The present study examined whether urinary semaphorin 3A levels predict the development of CI-AKI in patients undergoing PCI. This study enrolled 168 patients with stable angina undergoing elective PCI. Serial urine samples, obtained at baseline and 2, 6, 12, 24, 36, and 48 h post-PCI were analyzed by semaphorin 3A and neutrophil gelatinase-associated lipocalin (NGAL) ELISA kit...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Yong Liu, Kai-Hong Chen, Shi-Qun Chen, Li-Ling Chen, Chong-Yang Duan, Kun Wang, Xiao-Sheng Guo, Hua-Long Li, Wei-Jie Bei, Kai-Yan Lin, Ping-Yan Chen, Ying Xian, Ning Tan, Ying-Ling Zhou, Qing-Shan Geng, Ji-Yan Chen
[This corrects the article DOI: 10.18632/oncotarget.19034.].
February 6, 2018: Oncotarget
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
Nabeel Sarwani, Michael A Bruno, Marco D Huesch
OBJECTIVE: We sought to compare variability in serum creatinine among inpatients in our institution receiving contrast imaging studies and among inpatients not receiving such studies. MATERIALS AND METHODS: This retrospective, single-site, multiple-cohort study in a 550-bed academic medical center in October 2016 used the electronic medical record data to analyze the greatest absolute and relative changes in serum creatinine over periods no longer than 48 hours (1) during the admission for 1,134 patients who did not receive a contrast imaging study, (2) before the earliest contrast study for 155 patients who had not yet had a scheduled contrast examination, and (3) straddling the time when 266 patients received their earliest contrast study...
March 1, 2018: Journal of the American College of Radiology: JACR
Wen-Qi Yang, Shan Mou, Li Xu, Feng-Hua Li, Hong-Li Li
The goal of the study described here was to evaluate the degree of tubulointerstitial injury in patients with chronic kidney disease (CKD) using a more accurate model that combines renal sonographic parameters and laboratory biomarkers. A total of 308 patients were enrolled. The study protocol included conventional ultrasound, contrast-enhanced ultrasonography and renal biopsy. CKD patients were divided into normal and mild (≤25%), moderate (26%-50%) and severe (>50%) tubulointerstitial injury groups. We created a model comprising peak intensity, time to peak, urinary retinol-binding protein and β2 -microglobulin that could discriminate severe (>50%) tubulointerstitial injury...
March 1, 2018: Ultrasound in Medicine & Biology
Magaiver Andrade-Silva, Marcos Antônio Cenedeze, Luiz Augusto Perandini, Raphael José Ferreira Felizardo, Ingrid Mizuno Watanabe, Juan Sebastian Henao Agudelo, Ângela Castoldi, Giselle Martins Gonçalves, Clarice Silvia Taemi Origassa, Patricia Semedo, Meire Ioshie Hiyane, Orestes Foresto Neto, Denise Maria Avancini Costa Malheiros, Marlene Antonia Reis, Clarice Kazue Fujihara, Roberto Zatz, Alvaro Pacheco-Silva, Niels Olsen Saraiva Câmara, Danilo Candido de Almeida
Acute kidney injury (AKI) is considered an inflammatory disease in which Toll-like receptors (TLRs) signaling pathways play an important role. The activation of TLRs results in production of several inflammatory cytokines leading to further renal damage. In contrast, TLRs are key players on autophagy induction, which is associated with a protective function on cisplatin-induced AKI. Hence, this study aimed evaluate the specific participation of TLR2 and TLR4 molecules on development of cisplatin-induced AKI...
March 2, 2018: Clinical Science (1979-)
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
Paolo Calzavacca, Lindsea C Booth, Yugeesh R Lankadeva, Simon R Bailey, Louise M Burrell, Michael Bailey, Rinaldo Bellomo, Clive N May
INTRODUCTION: Supra-clinical doses of clonidine appear beneficial in experimental sepsis, but there is limited understanding of the effects of clonidine at clinically relevant doses. METHODS: In conscious sheep, with implanted renal and pulmonary artery flow probes, sepsis was induced by infusion of live Escherichia coli. At 24 hours, a high clinical dose of clonidine (HCDC) [1.0 μg/kg/h], a low clinical dose of clonidine (LCDC) [0.25 μg/kg/h] or vehicle, was infused for 8 hours...
February 27, 2018: Shock
Fabienne Aregger, Dominik E Uehlinger, Gerhard Fusch, Aldin Bahonjic, Rene Pschowski, Michael Walter, Joerg C Schefold
BACKGROUND: Acute kidney injury (AKI) is often observed in critically ill patients and is associated with high morbidity and mortality. Non-recovery from AKI has a negative impact on the prognosis of affected patients and early risk stratification seems key to improve clinical outcomes. We analyzed metabolites of a conserved key inflammatory pathway (i.e. tryptophan degradation pathway) in serial urine samples of patients with AKI. METHODS: One hundred twelve ICU patients with AKI were included in a prospective observational analysis...
February 26, 2018: BMC Nephrology
Sebastien Andrew Rider, Finnius Austin Bruton, Richard George Collins, Bryan Ronald Conway, John James Mullins
Defects in the glomerular filtration barrier (GFB) play a major role in the onset of human renal diseases. Highly ramified glomerular cells named podocytes are a critical component of the GFB. Injury to podocytes results in abnormal excretion of plasma proteins, which can lead to chronic kidney disease. The conserved paired nephron of larval zebrafish is an excellent model for assessing glomerular function and injury. The efficacy of two known podocyte toxins was tested to refine models of acute podocyte injury in larval zebrafish...
February 26, 2018: Zebrafish
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
Swapnil Hiremath, Jeanne Françoise Kayibanda, Benjamin J W Chow, Dean Fergusson, Greg A Knoll, Wael Shabana, Brianna Lahey, Olivia McBride, Alexandra Davis, Ayub Akbari
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is defined as worsening of renal function after the administration of iodinated contrast material. In patients with cardiovascular disease, kidney disease, and/or diabetes, renin-angiotensin system blockers, non-steroidal anti-inflammatory drugs, diuretics, and metformin can increase the risk of CI-AKI when undergoing contrast imaging. Despite CI-AKI being the leading iatrogenic cause of acute kidney injury, there is a lack of sufficient scientific evidence supporting which drugs should be stopped, when they should be stopped, and when they should be resumed...
February 21, 2018: Systematic Reviews
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
Kai-Yang Lin, Xiu-Ling Shang, Yan-Song Guo, Peng-Li Zhu, Zhi-Yong Wu, Hui Jiang, Jing-Ming Ruan, Wei-Ping Zheng, Zhe-Bin You, Chun-Jin Lin
We investigated whether preprocedural hyperglycemia was associated with contrast-induced acute kidney injury (CI-AKI) and long-term outcomes in patients with acute coronary syndrome (ACS) who underwent emergency percutaneous coronary intervention (PCI). Patients (n = 558) with ACS who underwent emergency PCI were consecutively enrolled. Preprocedural hyperglycemia was defined as glucose levels >198 mg/dL (11 mmol/L). The primary outcome was CI-AKI (≥0.3 mg/dL absolute or ≥50% relative serum creatinine increase 48 hours after contrast medium exposure)...
January 1, 2018: Angiology
Martijn van Griensven, Daniel Ricklin, Stephanie Denk, Rebecca Halbgebauer, Christian K Braun, Anke Schultze, Felix Hönes, Sofia Koutsogiannaki, Alexandra Primikyri, Edimara Reis, David Messerer, Sebastian Hafner, Peter Radermacher, Ali-Reza Biglarnia, Ranillo R G Resuello, Joel V Tuplano, Benjamin Mayer, Kristina Nilsson, Bo Nilsson, John D Lambris, Markus Huber-Lang
Trauma-induced hemorrhagic shock (HS) plays a decisive role in the development of immune, coagulation, and organ dysfunction often resulting in a poor clinical outcome. Imbalanced complement activation is intricately associated with the molecular danger response and organ damage after HS. Thus, inhibition of the central complement component C3 as turnstile of both inflammation and coagulation is hypothesized as a rational strategy to improve the clinical course after HS.Applying intensive care conditions, anaesthetized, monitored, and protectively ventilated non-human primates (NHP; cynomolgus monkeys) received a pressure-controlled severe HS (60 min at MAP 30 mmHg) with subsequent volume resuscitation...
February 14, 2018: Shock
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