Contrast-Induced Acute Kidney Injury: An Update

Chalikias, Georgios K.; Drosos, Ioannis; Tziakas, Dimitrios

doi:10.1007/s10557-015-6635-0

Cited by 73 publications

(68 citation statements)

References 112 publications

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“…Most of the contrast agents were used for enhanced computerized tomography to evaluate complications which included bleeding, infection, or leakage after gastric surgery in our study. Although the pathophysiology of contrast-induced AKI is very complex, it is well known that the use of contrast agents causes renal hypoxia and generation of reactive oxidative stress and has a direct cytotoxic effect on renal tubular epithelial cells [25]. Especially, low level of serum albumin and high intraoperative hypotension episode were associated with persistent AKI in our study.…”

Section: Discussionmentioning

confidence: 51%

Impact of Transient and Persistent Acute Kidney Injury on Chronic Kidney Disease Progression and Mortality after Gastric Surgery for Gastric Cancer

et al. 2016

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Acute kidney injury (AKI) is common after gastric surgery for gastric cancer and associated with adverse outcomes. However, the impact of transient or persistent AKI on clinical outcomes after gastric surgery for gastric cancer has not been described. We performed a retrospective study of 4,886 patients with normal renal function who underwent partial or total gastrectomy for gastric cancer between June 2002 and December 2012. AKI patients were classified as transient and persistent AKI based on the return of serum creatinine to the level indicating no AKI within 7 days. Our outcomes included occurrence of new-onset chronic kidney disease (CKD) and mortality 1 year after gastric surgery. AKI occurred in 638 (13.1%) after gastric surgery. Transient AKI was documented in 574 (90%). Use of diuretics and contrast agents was a common risk factor for persistent and transient AKI. Length of intensive care unit (ICU) and hospital stay, and ICU admission rate were higher in patients with transient AKI than in those without AKI. Although patients with persistent AKI had a higher new-onset CKD 1 year after gastric surgery after adjusting for multiple covariates, transient AKI was not associated with new-onset CKD. The 1-year mortality rates were significantly higher in patients with transient and persistent AKI. Not only persistent AKI but transient AKI is associated with increased risk of hospital complications and a significantly higher risk of long-term mortality than patients without AKI after gastric surgery. Moreover, persistent AKI, but not transient AKI, is associated with CKD progression at 1 year.

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Section: Discussionmentioning

confidence: 51%

Impact of Transient and Persistent Acute Kidney Injury on Chronic Kidney Disease Progression and Mortality after Gastric Surgery for Gastric Cancer

et al. 2016

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“…CIN could be the most simple, but also the most important AKI model to ascertain the value of Scys. To our knowledge, CIN is the third leading cause of AKI in hospitalized patients5152. There is a variety of novel bio-markers have been proposed to diagnose CIN.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Yong

Pei

Zhu

et al. 2017

Sci Rep

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The role of serum cystatin C (Scys) for the detection of acute kidney injury (AKI) has not been fully discussed. This meta-analysis was aimed to investigate the overall diagnostic accuracy of Scys for AKI in adults, and further identify factors affecting its performance. Studies before Sept. 2016 were retrieved from PubMed, Embase, Web of Science and the Cochrane Library. A total of 30 prospective cohort studies (involving 4247 adults from 15 countries, 982 patients occurring AKI) were included. The revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tools demonstrated no significant bias had influenced the methodological quality of the included studies. Scys showed a high predictive power for all-cause AKI, that the area under the receiver operating characteristic curve was 0.89. The detailed assessment parameters, such as sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for Scys were 0.82, 0.82, 4.6, 0.22 and 21, respectively. Although Scys could be slightly influenced by the following factors: settings, AKI diagnostic criteria, ethnicity, determination method, age and gender, these factors above did not reach statistically significance. In conclusion, Scys could be a vital promising marker to screen out AKI.

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“…CIN is currently the third leading cause of hospital-acquired acute kidney injury (11%) after decreased renal perfusion and medications [1]. In patients undergoing elective PCI, the reported incidence of CIN ranges from 2 to 20% [2,3]. However, the risk of CIN is significantly higher among patients with acute myocardial infarction (AMI) undergoing primary PCI (PPCI) [4,5], which is associated with not only prolonged hospital stays but also short- and long-term adverse cardiac events and a poor prognosis [6,7,8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

Protective Effects of Salvianolate on Contrast-Induced Nephropathy after Primary Percutaneous Coronary Intervention: A Prospective Multicenter Randomized Controlled Trial

Huang

Yuan²,

Ma³

et al. 2017

Cardiology

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Objectives: This study's aim was to evaluate the protective effects of salvianolate on contrast-induced nephropathy after primary percutaneous coronary intervention (PPCI) compared with normal saline (NS) hydration. Methods: We enrolled patients with acute myocardial infarction who underwent PPCI in 3 centers in Shanghai. The patients were randomly assigned to the salvianolate group or the NS group. The incidence of CIN, the changes in renal function parameters, and the occurrence of adverse events after the procedure were compared between the 2 groups. We used a multivariate logistic regression analysis to determine the independent correlates of CIN after PPCI. Results: A total of 484 patients were finally included in the statistical analysis. Compared with the control group, salvianolate reduced the incidence of CIN (9.1 vs. 16.3%, p = 0.018) after PPCI. The renal function parameters after PPCI in the salvianolate group were superior to those of the control group (p < 0.05). The composite adverse events rate was significantly lower in the salvianolate group within 1 month after the procedure (9.5 vs. 15.5%, p = 0.046). A higher peak of troponin I and loop diuretic therapy were the independent correlates of CIN after PPCI. Conclusions: Salvianolate reduces the incidence of CIN and protects renal function after PPCI, and the effects were superior to those of NS hydration.

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Contrast-Induced Acute Kidney Injury: An Update

Cited by 73 publications

References 112 publications

Impact of Transient and Persistent Acute Kidney Injury on Chronic Kidney Disease Progression and Mortality after Gastric Surgery for Gastric Cancer

Impact of Transient and Persistent Acute Kidney Injury on Chronic Kidney Disease Progression and Mortality after Gastric Surgery for Gastric Cancer

Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Protective Effects of Salvianolate on Contrast-Induced Nephropathy after Primary Percutaneous Coronary Intervention: A Prospective Multicenter Randomized Controlled Trial

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