Contrast-Induced Nephropathy: From Pathophysiology to Preventive Strategies

Azzalini, Lorenzo; Spagnoli, Vincent; Ly, Hung Q.

doi:10.1016/j.cjca.2015.05.013

Cited by 233 publications

(219 citation statements)

References 86 publications

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“…Therefore, we must obtain the serum creatinine value at hospital admission. We can easily define the patients who are prone to develop AKI (eGFR < 60 mL/min/1.73 m 2 , hemodynamic impairment, STEMI, diabetes, hypertension, hyperlipidemia, elderly) [1, 3-5] and instigate early nephroprotective strategies (low contrast volume, crystalloid infusions, measures to ensure optimal hemodynamics, discontinuation of nephrotoxic drugs, adjustment of anti-thrombotic drugs, radial access), which might provide a significant long-term benefit [5, 7, 16, 24, 25]. In cases of AKI, the consultation with a nephrologist would be beneficial for these patients.…”

Section: Discussionmentioning

confidence: 99%

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Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

et al. 2018

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Background: There are limited data regarding the incidence and long-term impact of acute kidney injury (AKI) according to the KDIGO guidelines on the outcome in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI). The aim of the study was to evaluate the prevalence of AKI, as classified by the KDIGO criteria, and its association with long-term mortality. Methods: Data from 5,859 MI patients undergoing PCI at our institution were analyzed. We compared the group without and with AKI according to the KDIGO criteria in relation to long-term mortality. Results: AKI was documented in 499 (8.5%) patients. AKI stage 1 occurred in 6.2% of patients, AKI stage 2 in 0.9% of patients, and AKI stage 3 in 1.5% of patients. Patients with AKI had a higher long-term mortality (57.3 vs. 20.6%; p < 0.0001). The mortality was 50.3% in AKI stage 1, 56.9% in AKI stage 2, and 87.2% in AKI stage 3. The hazard ratios for all-cause mortality for AKI stages 1–3 were 1.77, 1.85, and 6.30 compared to patients with no AKI. Cardiogenic shock, bleeding, heart failure, age, renal dysfunction, diabetes, hyperlipidemia, ST-elevation MI, contrast volume/glomerular filtration ratio, P2Y12 receptor antagonists, and radial access were associated with the development of AKI. Conclusion: A slight increase in serum creatinine was associated with a progressive increase in long-term mortality in patients with AKI according to the KDIGO definition.

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Section: Discussionmentioning

confidence: 99%

“…In this group, AKI is associated with contrast volume, hemodynamic impairment, inflammation, bleeding, and nephrotoxic agents [1, 3, 4]. However, the incidence of AKI reported varies considerably with the population evaluated and the definitions used [1, 6].…”

Section: Introductionmentioning

confidence: 99%

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

et al. 2018

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“…CIN is a decline in renal function that starts within 1 week after the administration of iodinated contrast in the absence of any other causes. 54 The decline can manifest either as a rise in serum creatinine >0.5 mg/dL or at least 25% relative to the patient's baseline. The pathogenesis is thought to be related to renal vasoconstriction brought about by the contrast medium as well as by direct nephrotoxic effects of the contrast.…”

Section: Complications Acute Kidney Injury (Aki)mentioning

confidence: 99%

Anesthesia for the Endovascular Management of Aortic Disease

Vázquez

Chitilian²

2016

International Anesthesiology Clinics

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“…1 CIN, which is mainly induced by iodinated contrast media (ICM), is an acute renal insufficiency occurred in patients with normal renal function, or a worsen of chronic renal insufficiency. 2 Although ICM is relatively safe, adverse events occurs from time to time.…”

Section: Chinese Medical Sciences Journal June 2017mentioning

confidence: 99%

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin?△

2017

Chinese Medical Sciences Journal

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Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography (FFA) remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy(CIN) and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.

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Contrast-Induced Nephropathy: From Pathophysiology to Preventive Strategies

Cited by 233 publications

References 86 publications

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

Anesthesia for the Endovascular Management of Aortic Disease

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin?△

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