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      Contrast-Induced Nephropathy: Update on the Use of Crystalloids and Pharmacological Measures

      review-article
      Author(s): , ,
      Publication date (Electronic):
      Journal: International Journal of Nephrology
      Publisher: Hindawi

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          Abstract

          Contrast-induced nephropathy (CIN) is a frequent and severe complication in subjects receiving iodinated contrast media for diagnostic or therapeutic purposes. Several preventive strategies were evaluated in the past. Recent clinical studies and meta-analyses delivered some new aspects on preventive measures used in the past and present. We will discuss all pharmacological and nonpharmacological procedures. Finally, we will suggest individualized recommendations for CIN prevention.

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          A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation.

          Roxana Mehran, Eve Aymong, Eugenia Nikolsky … (2004)
          We sought to develop a simple risk score of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). Although several risk factors for CIN have been identified, the cumulative risk rendered by their combination is unknown. A total of 8,357 patients were randomly assigned to a development and a validation dataset. The baseline clinical and procedural characteristics of the 5,571 patients in the development dataset were considered as candidate univariate predictors of CIN (increase >or=25% and/or >or=0.5 mg/dl in serum creatinine at 48 h after PCI vs. baseline). Multivariate logistic regression was then used to identify independent predictors of CIN with a p value 75 years, anemia, and volume of contrast) were assigned a weighted integer; the sum of the integers was a total risk score for each patient. The overall occurrence of CIN in the development set was 13.1% (range 7.5% to 57.3% for a low [ or=16] risk score, respectively); the rate of CIN increased exponentially with increasing risk score (Cochran Armitage chi-square, p < 0.0001). In the 2,786 patients of the validation dataset, the model demonstrated good discriminative power (c statistic = 0.67); the increasing risk score was again strongly associated with CIN (range 8.4% to 55.9% for a low and high risk score, respectively). The risk of CIN after PCI can be simply assessed using readily available information. This risk score can be used for both clinical and investigational purposes.
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            Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine

            Steven Weisbord, Martin Gallagher, Hani Jneid … (2017)
            Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy.
            Article 0 comments Cited 147 times – based on 0 reviews     Review now
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              Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial.

              Estelle Nijssen, Roger Rennenberg, Patty Nelemans … (2017)
              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.
              Article 0 comments Cited 134 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                D. Patschan:
                ORCID: http://orcid.org/0000-0002-6914-5254
                Journal
                Journal ID (nlm-ta): Int J Nephrol
                Journal ID (iso-abbrev): Int J Nephrol
                Journal ID (publisher-id): IJN
                Title: International Journal of Nephrology
                Publisher: Hindawi
                ISSN (Print): 2090-214X
                ISSN (Electronic): 2090-2158
                Publication date Collection: 2018
                Publication date (Electronic): 2 May 2018
                Volume: 2018
                Electronic Location Identifier: 5727309
                Affiliations
                Innere Medizin I, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany
                Author notes

                Academic Editor: Alejandro Ferreiro

                Author information
                http://orcid.org/0000-0002-6914-5254
                Article
                DOI: 10.1155/2018/5727309
                PMC ID: 5954945
                SO-VID: 8d3f7c2b-493a-4eb5-895c-034e96f570a5
                Copyright © Copyright © 2018 D. Patschan et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 December 2017
                Date revision received : 21 February 2018
                Date accepted : 14 March 2018
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Nephrology
                Data availability:
                ScienceOpen disciplines: Nephrology

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