Contrast nephropathy or contrast creatininopathy

Conti, C. Richard

doi:10.1002/clc.4960260202

Cited by 7 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Before these studies, most observers viewed CIN as a condition usually characterized by asymptomatic, minor, and transient elevations in the serum creatinine (SCr) without any significant associated morbidity or mortality (1). As reviewed below, recent studies have demonstrated convincingly that patients experiencing CIN have a greater risk of in-hospital and 1-yr mortality.…”

mentioning

confidence: 99%

Contrast-Induced Nephropathy

Rudnick¹,

Feldman²

2008

Clinical Journal of the American Society of Nephrology

145

120

View full text Add to dashboard Cite

Background and objectives:Observational studies have demonstrated that short-and long-term mortality is increased in patients who develop contrast-induced nephropathy (CIN). The more clinically relevant questions, and the objectives of this review, are whether CIN is causally related to mortality, and to what extent could mortality in patients undergoing contrast procedures be reduced by preventing CIN.Design, setting, participants, & measurements: A literature review was conducted, focusing on observational studies that assessed factors associated with mortality in patients with CIN.Results: The deaths of some patients with CIN are complicated by factors that cannot be directly related to CIN, such as liver disease, sepsis, respiratory failure, bleeding, etc. However, it is plausible that CIN contributes to cardiovascular causes of death in patients with CIN.Conclusions: At the very least, CIN is a marker for increased mortality. More carefully designed prospective studies are needed to fully elucidate the relationship between CIN and death. In the absence of data disproving a causal relationship between CIN and death in all subgroups, reducing its incidence should remain a goal in clinical practice as well as a target for future research.

show abstract

mentioning

confidence: 99%

Contrast-Induced Nephropathy

Rudnick¹,

Feldman²

2008

Clinical Journal of the American Society of Nephrology

145

120

View full text Add to dashboard Cite

show abstract

“…Recently, a large study (7), arguably with a relatively high degree of power and sound methods, seemed to confirm the beneficial effect of this agent. N-acetylcysteine is now being routinely recommended as preventative therapy, as an additive to low-osmolar contrast media and intravenous hydration, for patients with reduced renal function who are to undergo a planned exposure to radiocontrast media (8,9). Yet the reasons for discrepant findings among the trials need investigation before the widespread use of N-acetylcysteine can be recommended.…”

mentioning

confidence: 99%

N-Acetylcysteine for the Prevention of Radiocontrast Induced Nephropathy

Kshirsagar¹,

Poole²,

Mottl³

et al. 2004

Journal of the American Society of Nephrology

210

View full text Add to dashboard Cite

Abstract. N-acetylcysteine has been recommended for patients with renal insufficiency who are to receive radiocontrast media. However, trials of oral N-acetylcysteine for the prevention of radiocontrast-induced nephropathy have yielded inconsistent results. A systematic review of patient and study characteristics was undertaken to discover possible explanations of the inconsistencies. The databases MEDLINE, EMBASE, and CENTRAL (1966 to March 2003) were searched in all languages, and conference proceedings from several professional societies from the years 1999 to 2003 were also searched. Only prospective controlled trials of oral N-acetylcysteine were included. Risk difference estimates and 95% confidence intervals were calculated. The estimates were examined for evidence of publication bias and heterogeneity. Stratified and meta-regression analyses were used to compare estimates by study and patient characteristics. Identified were 16 studies, 15 published and 1 unpublished. There was no evidence of publication bias, but there was substantial evidence of heterogeneity, thus precluding reliance on a meaningful summary effect estimate. Meta-regression identified several patient and study characteristics, with some evidence of association with study-specific estimates. None of these characteristics, however, formed subsets of studies with results that were homogeneous enough to aggregate. Research on N-acetylcysteine and the incidence of radiocontrast nephropathy is too inconsistent at present to warrant a conclusion on efficacy or a recommendation for its routine use. Identified patient and study characteristics may be responsible for some, but not all, of this inconsistency. A large, randomized, placebo-controlled trial, a pooled analysis of patient-level data, or both may resolve this issue.Over the last 3 yr, enthusiasm for the use of oral N-acetylcysteine to prevent radiocontrast-induced nephropathy has been growing (1). A breakthrough study (2) first reported a large and significant reduction in the risk of radiocontrast-induced nephropathy compared with placebo among patients with moderate renal dysfunction. Subsequent studies produced mixed results (3-6). Recently, a large study (7), arguably with a relatively high degree of power and sound methods, seemed to confirm the beneficial effect of this agent. N-acetylcysteine is now being routinely recommended as preventative therapy, as an additive to low-osmolar contrast media and intravenous hydration, for patients with reduced renal function who are to undergo a planned exposure to radiocontrast media (8,9). Yet the reasons for discrepant findings among the trials need investigation before the widespread use of N-acetylcysteine can be recommended.We therefore performed a systematic review and metaanalysis of available prospective controlled trials to quantify and compare reported associations of oral N-acetylcysteine with the incidence of nephropathy after exposure to radiocontrast media. For this review, we examined several key questions. Is there evidenc...

show abstract

“…Mortality at 30‐day was similar in patients with and without DRF (4.2% vs 3.2%), but more patients died in the DRF group by the end of the observation period (18.9% vs 14%; P = 0.001). Although DRF did not independently predict long‐term mortality, this finding highlights the following points: (i) minor sCr increase after CM administration are not considered clinically relevant, and the terminology “creatinopathy” has been used to identify this group of patients and (ii) individuals with high risk (such as those hospitalized in Intensive Care Unit) may develop AKI even without being subjected to CM exposure …”

Section: Ci‐aki Definitionmentioning

confidence: 86%