Impact of the Definition Utilized on the Rate of Contrast-Induced Nephropathy in Percutaneous Coronary Intervention

Jabara, Refat; Gadesam, Radhika; Pendyala, Lakshmana; Knopf, William D.; Chronos, Nicolas; Chen, Jack P.; Viel, Kevin R.; King, Spencer B.; Manoukian, Steven V.

doi:10.1016/j.amjcard.2009.02.039

Cited by 64 publications

(46 citation statements)

References 14 publications

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“…The RCM-AKI incidence observed in the present study compares favorably with the 10%-20% in the ACS population. The RCM-AKI incidences in the 3 most recent coronary intervention studies are all higher than that observed in our cohort: 11.5% (45/392, P ϭ .008) reported by Wickenbrock et al, 15 10.2% (41/400, P Ͻ .03) reported by Jabara et al, 16 and 20.5% (115/561, P Ͻ .0001) reported by Marenzi et al 17 In pooling the 201 separate…”

Section: Discussioncontrasting

confidence: 39%

“…Although the incidence reported in the literature concerning endovascular interventions for ACS ranges from 10% to 20%, [15][16][17] our small study size makes it impossible to make a fair intercohort comparison. A much larger study is required to determine the true incidence of RCM-AKI in endovascularly treated patients with AIS before such comparison can be made.…”

Section: Discussionmentioning

confidence: 91%

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The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low

Loh

McArthur²,

Vespa³

et al. 2010

AJNR Am J Neuroradiol

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Section: Discussioncontrasting

confidence: 39%

Section: Discussionmentioning

confidence: 91%

The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low

Loh

McArthur²,

Vespa³

et al. 2010

AJNR Am J Neuroradiol

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“…(Critical Care Nurse. 2012;32 [6]: [15][16][17][18][19][20][21][22][23][24] This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:…”

Section: Contrast-induced Nephropathy In Critical Carementioning

confidence: 99%

Contrast-Induced Nephropathy in Critical Care

Wood

2012

Critical Care Nurse

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minutes before the imaging study to protect against contrast-induced nephropathy (CIN). Because of the frequency of nausea and vomiting associated with use of N-acetylcysteine, a nurse practitioner in the department suggests that the patient be given an infusion of sodium bicarbonate 150 mEq/L at a rate of 3.5 mL/kg per hour for 1 hour before the CT scan. A hospitalist who is with another patient overhears the discussion and adds that some evidence suggests that hydration with physiological saline at 1 mL/kg per hour may suffice.What is CIN and what is the best course of action for this patient? In this article, I describe CIN; the patients at risk for this abnormality; and the etiology, pathophysiology, preventive interventions, and treatments for this iatrogenic complication of imaging with contrast material. BackgroundCIN is a disorder characterized by the onset of acute renal failure within 24 to 72 hours after the administration of iodinated contrast medium. Contrast-induced nephropathy is an iatrogenic disease caused by the administration of iodinated contrast material to certain at-risk patients. The clinical features include renal failure, with oliguria, anuria, and electrolyte derangements. Contrastinduced nephropathy can prolong hospitalization, result in greater morbidity and mortality, and increase patients' costs. A variety of preventive and treatment strategies exist, including use of alternative imaging. Critical care nurses need to understand the nephropathy and the patients at risk and to develop a familiarity with prevention, treatment, and outcome. (Critical Care Nurse. 2012;32[6]:15-24) This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. State the pathophysiology of contrast-induced nephropathy 2. Identify patients at risk for developing contrast-induced nephropathy 3. State preventive therapies useful in high-risk patients CNEContinuing Nursing EducationA 62-year-old woman with a history of congestive heart failure and type 2 diabetes mellitus comes to the emergency department because she has had pain in the left lower quadrant of her abdomen and fever for 3 days.by AACN on May 9, 2018 http://ccn.aacnjournals.org/ Downloaded from typically asymptomatic, although a few patients experience renal dysfunction and may require dialysis. Despite its typically mild manifestations, CIN is associated with increases in hospital stays, [4][5][6] in-hospital mortality, 7,8 and 1-year mortality. 4,5,7 Lengths of stay can be twice as long as the stays of patients without CIN, 4,6 and both inpatient and 30-day mortality can be as much as 10-fold greater. 4,6,8 Several populations of patients are at risk, including patients with preexisting renal disease, congestive heart failure, and diabetes mellitus. Several treatment regimens are available to protect the kidneys during administration of contrast material. Contrast MediaContrast media are used in a wide array of medical imaging, inclu...

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“…These results are approximately the same as those of previous reports using the same diagnostic criteria. 4 In this study, the proportion of shock patients is high, and the possibility that it affected renal function cannot be denied. Investigations at other institutions are planned.…”

mentioning

confidence: 99%