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Contrast Induced Nephropathy

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Pierre Aubry, Georges Brillet, Laura Catella, Aurélie Schmidt, Stève Bénard
BACKGROUND: Despite the use of low-osmolar contrast media that have significantly reduced the occurrence of severe adverse reactions, contrast-induced (CI) acute kidney injury (AKI) remains the third cause of AKI in hospitals. We sought to estimate the frequency of CI-AKI among hospitalized patients undergoing image-guided cardiovascular procedures, to quantify the effect of risk factors on the development of this complication and to assess relative organizational and economic burden in healthcare...
November 8, 2016: BMC Nephrology
Gillian Balbir Singh, Soe Hee Ann, Jongha Park, Hyun Chul Chung, Jong Soo Lee, Eun-Sook Kim, Jung Il Choi, Jiho Lee, Shin-Jae Kim, Eun-Seok Shin
OBJECTIVE: Remote ischemic preconditioning (RIPC) induces transient episodes of ischemia by the occlusion of blood flow in non-target tissue, before a subsequent ischemia-reperfusion injury. When RIPC is applied before percutaneous coronary intervention (PCI), the kidneys may be protected against ischemia-reperfusion injury and subsequently contrast-induced acute kidney injury (CI-AKI). The aim of this study was to evaluate the efficacy of RIPC for the prevention of CI-AKI in patients with diabetes with pre-existing chronic kidney disease (CKD) undergoing elective PCI...
2016: PloS One
Xiaole Su, Xinfang Xie, Lijun Liu, Jicheng Lv, Fujian Song, Vlado Perkovic, Hong Zhang
BACKGROUND: To simultaneously evaluate the relative efficacy of multiple pharmacologic strategies for preventing contrast-induced acute kidney injury (AKI). STUDY DESIGN: Systematic review containing a Bayesian network meta-analysis of randomized controlled trials. SETTING & POPULATION: Participants undergoing diagnostic and/or interventional procedures with contrast media. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials comparing the active drug treatments with each other or with hydration alone...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Emilee Wilhelm-Leen, Maria E Montez-Rath, Glenn Chertow
Estimates of the incidence of radiocontrast-associated nephropathy vary widely and suffer from misclassification of the cause of AKI and confounding. Using the Nationwide Inpatient Sample, we created multiple estimates of the risk of radiocontrast-associated nephropathy among adult patients hospitalized in the United States in 2009. First, we stratified patients according to the presence or absence of 12 relatively common diagnoses associated with AKI and evaluated the rate of AKI between strata. Next, we created a logistic regression model, controlling for comorbidity and acuity of illness, to estimate the risk of AKI associated with radiocontrast administration within each stratum...
September 29, 2016: Journal of the American Society of Nephrology: JASN
Martine Ann Harris, Beverly Snaith, Ruth Clarke
OBJECTIVE: To identify current UK screening practices prior to contrast-enhanced CT. To determine the patient management strategies to minimize the risk of contrast-induced acute kidney injury (CI-AKI) risk in outpatients. METHODS: An invitation to complete an electronic survey was distributed to the CT managers of 174 UK adult National Health Service hospital trusts. The survey included questions related to local protocols and national guidance on which these are based...
November 2016: British Journal of Radiology
A J George, N E Manghat, M C K Hamilton
AIM: To compare a fixed-dose intravenous iodinated contrast medium protocol with weight-based dosing protocols for abdominal computed tomography (CT). MATERIALS AND METHODS: Fifty patients were scanned using a fixed-dose protocol, 50 patients were scanned using a full-dose weight-based contrast dosing protocol, and 13 patients were scanned using a reduced dose weight-based protocol. Radiodensity was measured at the portal vein, aorta, spleen, and liver. These values were plotted against contrast medium dose per unit weight...
August 21, 2016: Clinical Radiology
Osamu Kurihara, Yoshihiko Seino, Yusaku Shibata, Masato Matsushita, Hidenori Komiyama, Katsuhito Kato, Daisuke Murakami, Ryo Munakata, Masamichi Takano, Yasushi Miyauchi, Noritake Hata, Wataru Shimizu
Contrast media are considered to cause acute kidney injury by activating various factors that induce renal vasoconstriction. We analysed the renal microvascular haemodynamic response using the Doppler flow wire method. Then changes in urinary liver-type fatty acid-binding protein levels following contrast medium administration were compared between groups with or without a micro-injury of the kidney. In the group without renal micro-injury, the average peak velocity (APV) decreased significantly, whereas the renal artery resistance index (RI) increased significantly following contrast medium administration...
August 25, 2016: Clinical and Experimental Pharmacology & Physiology
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
PURPOSE OF REVIEW: To highlight the most recently published meta-analyses on the role of statins in the prevention of contrast-induced acute kidney injury (CI-AKI) and to formulate recommendations for clinical practice. RECENT FINDINGS: Nine meta-analyses were published on this topic from January 2015 to April 2016. Significant clinical heterogeneity between studies, regarding study population, treatment protocol, concomitant preventive strategies or dosage and duration of statin therapy was observed...
November 2016: Current Opinion in Nephrology and Hypertension
Jennifer S McDonald, Caleb B Leake, Robert J McDonald, Rajiv Gulati, Richard W Katzberg, Eric E Williamson, David F Kallmes
OBJECTIVES: The aim of this study was to determine whether intra-arterial administration of contrast material is associated with a higher risk of acute kidney injury (AKI) compared with that of intravenous (IV) administration in a cohort of patients that received both routes of administration. MATERIALS AND METHODS: All patients who received both a contrast-enhanced computed tomography (CT) and a diagnostic or interventional cardiac catheterization between 2000 and 2014 were identified...
June 14, 2016: Investigative Radiology
Mehmet Kanbay, Yalcin Solak, Baris Afsar, Ionut Nistor, Gamze Aslan, Ozlem Hilal Çağlayan, Asli Aykanat, Mihaela-Dora Donciu, Miguel A Lanaspa, Ahsan A Ejaz, Richard J Johnson, Adrian Covic
Contrast-induced acute kidney injury (CI-AKI) is a common cause of hospital-acquired acute kidney injury (AKI). We evaluated the evidence that uric acid (UA) plays a pathogenic role in CI-AKI. Ten studies were eligible for inclusion for meta-analysis. Hyperuricemia predicted risk for cases with AKI in prospective cohort studies. Higher levels of serum UA (SUA), as defined by the authors, were associated with a 2-fold increased risk to develop AKI (pooled odds ratio 2.03; 95% confidence interval [CI] 1.48-2...
February 2017: Angiology
Anand Prasad, Carolina Ortiz-Lopez, Aazib Khan, Daniel Levin, David M Kaye
INTRODUCTION: Radiographic contrast administration is a major cause of acute kidney injury (AKI), worldwide. Currently, contrast induced acute kidney injury (CI-AKI) is the third leading cause of hospital acquired renal failure in the United States. Over 50% of these cases are the result of contrast exposure during cardiac catheterization. The predictive risk factors for and clinical impact of AKI following coronary procedures have been extensively studied and documented in the literature...
August 2016: Catheterization and Cardiovascular Interventions
Giovani José Dal Poggetto Molinari, Ana Terezinha Guillaumon, Andréia Marques de Oliveira Dalbem
INTRODUCTION: Despite the patient and medical staff exposure to radiation in endovascular aneurysm repair, the benefits of this abdominal aortic aneurysm type of surgical management are justified by minor recovery time and hospitalization, as well as an option for patients not elected to conventional open repair. In this minimally invasive surgical approach, time of procedure and radiation doses can be substantial--and the increasing frequency of these procedures and it's complexity have impelled vascular surgeons to face additional and successive risk to occupational radiation exposure...
November 2015: Brazilian Journal of Cardiovascular Surgery
Marco Centola, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Giulia Ferrante, Roberta Acquaviva, Diego Castini, Marianna Spina, Federico Lombardi, Mario Cozzolino, Stefano Carugo
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is associated with significantly increased mortality after primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI). The prognostic value of CI-AKI depends on the definitions used to define it. We compare the predictive accuracy of long-term mortality of two definitions of CI-AKI on consecutive patients undergoing pPCI for STEMI. METHODS: Incidence, risk factors and long-term prognosis of CI-AKI were assessed according to two different definitions: the first as an increase in serum creatinine ≥ 25% or ≥ 0...
May 1, 2016: International Journal of Cardiology
I C Bostock, D S Zarkowsky, C W Hicks, D H Stone, M H Eslami, M B Malas, P P Goodney
Contrast-induced nephropathy after endovascular aortic aneurysm repair (EVAR) in kidney transplant recipients (KTRs) can have devastating consequences. The Vascular Quality Initiative (VQI) database was queried to select all KTRs who underwent EVAR between January 2003 and December 2014. Our primary outcome was renal dysfunction, defined as acute kidney injury (AKI; elevation of serum creatinine >0.5 mg/dL from baseline) or new postoperative hemodialysis requirement. Within the EVAR VQI dataset, 40 patients were KTRs (40 of 17 213, or 0...
August 2016: American Journal of Transplantation
Nelson Wang, Pierre Qian, Tristan D Yan, Kevin Phan
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a potential complication in coronary angiography (CAG) and percutaneous coronary interventions (PCI). Prior randomized controlled trials (RCTs) have suggested that statins may play a role in reducing rates of CI-AKI, however it is not clear how firm the current evidence is. OBJECTIVES: The aim of this study was to conduct a meta-analysis and trial sequential analysis to determine the effects of statins in lowering CI-AKI rates in CAG and PCI...
March 1, 2016: International Journal of Cardiology
Mohammad Reza Khatami, Nasrin Nikravan, Mojtaba Salari-Far, Safieh Davoudi, Mohammad Reza Pahlavan-Sabbagh
Contrast-induced nephropathy (CIN) is the third leading cause of acute kidney injury in hospitalized patients. The prevalence of CIN is reported to range from 0% to 50%, depending not only on patient condition and the procedure used but also the definition of CIN applied. We aimed to determine the best diagnostic indicator of CIN in patients with normal serum creatinine. This study included 206 patients with normal serum creatinine who underwent coronary angiography/angioplasty. Serum creatinine level and glomerular filtration rate (GFR) were measured before and on the second and fifth days after contrast administration...
January 2016: Saudi Journal of Kidney Diseases and Transplantation
Abid Malik
The number of interventional and diagnostic contrast procedures has increased year on year and contrast-induced acute kidney injury has become a leading cause of inpatient mortality and morbidity. This article summarizes how to identify the high-risk patient and gives a systematic approach to prevent contrast-induced acute kidney injury.
December 2015: British Journal of Hospital Medicine
S Winther, M Svensson, H S Jørgensen, H Birn, H E Bøtker, P Ivarsen, M Bøttcher
Patients with chronic kidney disease (CKD) frequently require radiographic examinations. We investigated the impact of repeated contrast administrations on short- and long-term kidney function and mortality in kidney transplantation candidates. In a prospective study, 81 predialysis transplantation candidates underwent computed tomography angiography (CTA) and invasive coronary angiography (ICA) as part of a pretransplant cardiovascular evaluation. Postcontrast plasma creatinine (P-creatinine) changes were compared with a precontrast control period...
March 2016: American Journal of Transplantation
Carlos Andres Zapata-Chica, Diana Bello Marquez, Lina Maria Serna-Higuita, John Fredy Nieto-Ríos, Fabian David Casas-Arroyave, Jorge Hernando Donado-Gómez
INTRODUCTION: Contrast-induced nephropathy is one of the main causes of acute kidney injury and increased hospital-acquired morbidity and mortality. The use of sodium bicarbonate for nephroprotection has emerged as a preventative strategy; however, its efficacy is controversial compared to other strategies, such as hydration using 0.9% saline solution. OBJECTIVE: To compare the effectiveness of sodium bicarbonate vs. hydration using 0.9% saline solution to prevent contrast-induced acute kidney injury...
July 2015: Colombia Médica: CM
Julian L Wichmann, Richard W Katzberg, Sheldon E Litwin, Peter L Zwerner, Carlo N De Cecco, Thomas J Vogl, Philip Costello, U Joseph Schoepf
No abstract text is available yet for this article.
November 17, 2015: Circulation
2015-12-04 12:10:46
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