Contrast-Induced Acute Kidney Injury: Review and Practical Update

Morcos, Ramez; Kucharik, Michael P.; Bansal, Pirya; Taii, Haider Al; Manam, Rupesh; Casale, Joel; Khalili, Houman; Maini, Brijeshwar

doi:10.1177/1179546819878680

Cited by 69 publications

(63 citation statements)

References 63 publications

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“…A previous study showed that CI-AKI is associated with major adverse clinical outcomes and death [5]. Once CI-AKI occurs, there is no specific treatment; hence, prevention by minimizing contrast administration and Intravenous (IV) fluid hydration is the optimal management strategy [6]. However, clinical data regarding their feasibility, efficacy, and safety are limited [7].…”

Section: Introductionmentioning

confidence: 99%

Acetylbritannilactone attenuates contrast-induced acute kidney injury through its anti-pyroptosis effects

Chen

Yang

et al. 2020

Bioscience Reports

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Contrast-induced acute kidney injury (CI-AKI) is a severe complication caused by intravascular applied radial contrast media (CM). Pyroptosis is a lytic type of cell death inherently associated with inflammation response and the secretion of pro-inflammatory cytokines following caspase-1 activation. The aim of the present study was to investigate the protective effects of acetylbritannilactone (ABL) on iopromide (IOP)-induced acute renal failure and reveal the underlying mechanism. In vivo and in vitro, IOP treatment caused renal damage and elevated the caspase-1 (+) propidium iodide (PI) (+) cell count, interleukin (IL)-1β and IL-18 levels, lactate dehydrogenase (LDH) release, and the relative expression of nucleotide-binding domain, leucine-rich repeat containing protein 3 (NLRP3), apoptosis-associated speck-like protein (ASC), and gasdermin D (GSDMD), suggesting that IOP induces AKI via the activation of pyroptosis. Furthermore, the pretreatment of ABL partly mitigated the CI-AKI, development of pyroptosis, and subsequent kidney inflammation. These data revealed that ABL partially prevents renal dysfunction and reduces pyroptosis in CI-AKI, which may provide a therapeutic target for the treatment of CM-induced AKI.

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Section: Introductionmentioning

confidence: 99%

Acetylbritannilactone attenuates contrast-induced acute kidney injury through its anti-pyroptosis effects

Chen

Yang

et al. 2020

Bioscience Reports

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“…Previous studies have reported that the incidence of CIN was 3%, and more than 50% of patients experienced CIN for high-risk individuals following PCI [ 19 – 21 ]. Although the mechanism is not yet clear, however, it is believed that the complication is closely related to renal hemodynamic changes, toxic injury of renal tubular epithelial cells, and decrease in nitric oxide production, intracellular calcium overload, and oxidative stress [ 22 – 24 ]. According to the different pathogenesis, many therapies on preventing CIN have emerged.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Nicorandil in Preventing Contrast-Induced Nephropathy after Elective Percutaneous Coronary Intervention: A Pooled Analysis of 1229 Patients

Jiang

et al. 2020

Journal of Interventional Cardiology

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Background. Nicorandil in reducing contrast-induced nephropathy (CIN) following elective percutaneous coronary intervention (PCI) is an inconsistent practice. This article aims to evaluate the efficacy and safety of nicorandil in preventing CIN after elective PCI. Methods. This is a pooled analysis of patients treated with elective PCI. The primary outcome was the incidence of CIN. The secondary outcomes were major adverse events, including mortality, heart failure, recurrent myocardial infarction, stroke, and renal replacement therapy. Results. A total of 1229 patients were recruited in our study. With statistical significance, nicorandil lowered the risk of CIN (odds ratio = 0.26; 95% confidence interval = 0.16–0.44; P<0.00001; I2 = 0%) in patients who underwent elective PCI. In addition, no significant differences were observed in the incidence of mortality, heart failure, recurrent myocardial infarction, stroke, and renal replacement therapy between the two groups (P>0.05). Conclusions. Our article indicated that nicorandil could prevent CIN without increasing the major adverse events. Furthermore, sufficiently powered and randomized clinical studies are still needed in order to determine the role of nicorandil in preventing CIN after elective PCI.

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“…Moreover, vasoconstriction is known to increase blood viscosity after CM administration. CM increased viscosity and tubular pressure, exacerbating renal hypoperfusion and promote a decrease in urine flow rate, leading to its retention and allowing its continuous cytotoxicity [ Figure 1] [64,65] . Furthermore, blood viscosity is a key player in CVD pathophysiology and is associated with increased risks of CVD [66,67] .…”

Section: Cin Pathophysiology In the Context Of Cvdmentioning

confidence: 99%

Oxidative stress and inflammation in the development of cardiovascular disease and contrast induced nephropathy

Cervantes-Gracia

Raja²,

Llanas-Cornejo

et al. 2020

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Utilization of contrast media to visualize vasculature structures in the setting of cardiovascular disorders (CVD) can lead to acute kidney injury, referred to as contrast-induced nephropathy (CIN). CIN can potentiate mortality and hospitalization in aged individuals, patients with CVD, nephropathy, enhancing kidney damage, and cardiac events. Preventing CIN by identifying risk factors is important. The underlying mechanisms of CIN pathology are unclear, but the key factors include direct cytotoxicity, oxidative stress, vascular and endothelial dysfunction and inflammatory processes. Reactive Oxygen Species and inflammatory mediators have been proposed as key factors influencing the development of CIN and CVD, and the elucidation of the interplay between the mechanisms evoked by them may provide a better understanding of the signaling processes happening in these conditions, thereby potentially enabling early identification, prevention and characterization of novel drug targets.

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Contrast-Induced Acute Kidney Injury: Review and Practical Update

Cited by 69 publications

References 63 publications

Acetylbritannilactone attenuates contrast-induced acute kidney injury through its anti-pyroptosis effects

Acetylbritannilactone attenuates contrast-induced acute kidney injury through its anti-pyroptosis effects

Efficacy and Safety of Nicorandil in Preventing Contrast-Induced Nephropathy after Elective Percutaneous Coronary Intervention: A Pooled Analysis of 1229 Patients

Oxidative stress and inflammation in the development of cardiovascular disease and contrast induced nephropathy

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