Contrast induced nephropathy in patients undergoing primary percutaneous coronary intervention without acute left ventricular ejection fraction impairment

Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction

“…Although there are some compounding factors in the definition of CIN in patients with AMI as mentioned above, CIN is a powerful predictor of major adverse clinical events in these patients . In the present study, we demonstrated that the in‐hospital mortality rate was higher in patients with CIN than in patients without CIN, and the incidence of acidosis soon after reperfusion was associated with CIN when adjusted for well‐known predictors or risk scoring system.…”

“…Contrast‐induced nephropathy (CIN) is associated with poor outcomes in patients with acute myocardial infarction (AMI) . CIN is caused by renal vasoconstriction, renal hypoxia, and direct toxicity on tubular epithelial cells caused by contrast medium exposure.…”

Predictive value of inflammatory factors on contrast‐induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention

“…Contrast medium administration during PCI may be complicated by transient renal dysfunction or ongoing renal function deterioration, which is known as CI‐AKI. With the diverse application of PCI technology in patients with CAD, CI‐AKI has become one of the most serious complications of PCI, especially in the setting of ACS, and CI‐AKI is associated with increased morbidity and mortality . There is no effective treatment for CI‐AKI, which emphasizes the need for clinical prevention efforts for CI‐AKI.…”

“…The pathogenesis of CI‐AKI has not yet been completely understood, and multiple mechanisms, including a direct cytotoxic effect of the contrast medium, intrarenal vasoconstriction, renal medullary hypoxia, ischemic injury, and oxidative stress, as well as activation of inflammatory processes, may be involved . There is no effective treatment for CI‐AKI, which emphasizes the need for clinical prevention efforts for CI‐AKI . Though inflammation is reported to play an important role in the development of CI‐AKI, especially in the setting of ACS, the popularized risk score models, such as Mehran's and Bartholomew's risk scoring systems, do not address inflammatory factors .…”

Acute kidney injury after primary angioplasty

“…7,8 Moreover CI-AKI has been associated with increased mortality, [9][10][11][12] even after adjustment for concurrent predictors of unfavorable outcome, such as pre-existent kidney disease and left-ventricular failure. 13,14 Several strategies to prevent CI-AKI, including normal saline, 15 sodium bicarbonate, 16 and the administration of N-acetylcysteine, 17 have been investigated in the past. However, their efficacy in prevention of CI-AKI, especially in the setting of STEMI patients undergoing PPCI, remains largely inconclusive and no specific prophylaxis (therapy to prevent CI-AKI) is currently recommended in this setting, apart from moderate hydration.…”