Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose

Freeman, Rosario V.; O’Donnell, Michael J.; Share, David; Meengs, William L.; Kline–Rogers, Eva; Clark, Vivian L.; DeFranco, Anthony; Eagle, Kim A.; McGinnity, John G.; Patel, Kirit; Maxwell-Eward, Ann; Bondie, Diane; Moscucci, Mauro

doi:10.1016/s0002-9149(02)02771-6

Cited by 307 publications

(254 citation statements)

References 26 publications

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“…2 The effects of CM are compounded by increased comorbidities in patients receiving them, including pre-existing renal impairment with or without concurrent diabetes, the use of drugs that affect renal function, advanced age, and the use of large volumes of CM. 3 CIN is an acute decline in renal function occurring after intravascular contrast administration and the absence of an alternative cause. 4,5 CIN has been variably defined: a postcontrast increase in serum creatinine (SCr) levels of at least 0.5 mg/dL or of more than 25% above precontrast values.…”

mentioning

confidence: 99%

No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal Contrast Medium

Langner¹,

Stumpe²,

Kirsch³

et al. 2008

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Contrast-induced nephropathy (CIN) is one of the most common causes of in-hospital acute renal failure. The aim of this study was to assess the risk for CIN after repeated administration of the nonionic, dimeric, iso-osmolal contrast agent iodixanol regardless of pre-existing renal function. Changes in serum creatinine (SCr) levels were compared with those of control subjects who did not receive iodinated contrast media (CM).

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mentioning

confidence: 99%

No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal Contrast Medium

Langner¹,

Stumpe²,

Kirsch³

et al. 2008

AJNR Am J Neuroradiol

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“…Among patients with cardiogenic shock, one-stage multivessel PCI was associated with worse outcomes compared with single-vessel culprit PCI [101] and was associated with more complications than culprit stenosis PCI followed by delayed nonculprit stenosis PCI [106,107]. Culprit stenosis PCI with subsequent PCI of additional important stenoses during the same hospitalization has been recommended as the best strategy in patients with cardiogenic shock [102].…”

Section: Cardiogenic Shockmentioning

confidence: 99%

“…Several studies have associated total contrast load with the incidence of contrast-induced nephropathy (CIN) [105,106]. Contrast doses <100 cm 3 rarely cause CIN [107] in patients with normal or mildly impaired renal function, but the incidence of CIN increases by 14% for each 50 cm 3 increase in contrast volume [108], and contrast doses over 260 cm 3 particularly predispose patients to CIN [109].…”

Section: Procedural Considerations Managing Radiographic Contrastmentioning

confidence: 99%

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

Blankenship

Moussa

Chambers

et al. 2011

Cathet Cardio Intervent

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Percutaneous coronary interventions (PCIs) to treat multivessel coronary artery disease (MVCAD) may involve single-vessel or multivessel interventions, performed in one or more stages. This consensus statement reviews factors that may influence choice of strategy and includes six recommendations to guide decisions regarding staging of PCI [1]. Every patient who undergoes PCI should receive optimal therapy for coronary disease, ideally before starting the procedure [2]. Multivessel PCI at the time of diagnostic catheterization should be considered only if informed consent included the risks and benefits of multivessel PCI and the risks and benefits of alternative treatments [3]. When considering multivessel PCI, the interventionist should develop a strategy regarding which stenoses to treat or evaluate, and their order, method, and timing. This strategy should maximize patient benefits, minimize patient risk, and consider the factors described in this article [4]. For planned multivessel PCI, additional vessel(s) should be treated only if the first vessel is treated successfully and if anticipated contrast and radiation doses and patient and operator conditions are favorable [5]. After the first stage of the planned multistage PCI, the need for subsequent PCI should be reviewed before it is performed [6]. Third party payers and quality auditors should recognize that multistage PCI for MVCAD is neither an indication of poor quality nor an attempt to increase reimbursement when performed according to recommendations in this article.V C 2011 Wiley Periodicals, Inc.

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“…A nefropatia por contraste soma-se à outros fatores de agressão renal no período peri-operatório como sangramento e hipovolemia, trauma cirúrgico, doença aterosclerótica e substân-cias nefrotóxicas 13 podendo ser causa de terapia dialítica. Estudos relatam incidência de 0,44% de necessidade de diálise após intervenção coronariana com contraste 14 . São descritos como fatores de risco para nefropatia por contraste: diabete melito, idade maior que 75 anos, hipovolemia, insuficiência cardíaca, cirrose, nefrose, hipertensão arterial, proteinúria, uso de antiinflamatório e injeção intra-arterial de contraste 15 .…”

Section: Circulação Extracorpóreaunclassified

“…35 . Além disso, recomenda-se que se utilize a menor dose possível visto que doses maiores que 5 mL.kg -1 divididos pela creatinina plasmática em mg.dL -1 estão associados à maior risco (Tabela 5) 14 . Não existem estudos sobre a utilização da solução de bicarbonato de sódio no contexto peri-operatório, no entanto os pacientes neste cenário possuem múltiplos fatores de agressão renal e maior potencial de complicação podendo beneficiar-se dessa solução, caso seja necessária a utilização de contraste.…”

Section: N-acetilcisteínaunclassified

Proteção renal na unidade de terapia intensiva cirúrgica

Santos¹,

Hajjar²,

Galas³

et al. 2006

Rev. bras. ter. intensiva

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RESUMO JUSTIFICATIVA E OBJETIVOS:A disfunção renal perioperatória é importante causa de aumento de morbimortalidade. Com o aumento da expectativa de vida, pacientes mais idosos e com maior números de co-morbidades estão sendo submetidos à procedimentos cirúrgicos de alto risco, o que torna as práticas da proteção orgânica possíveis modificadoras de prognóstico a curto e longo prazo. Nesse contexto, esta revisão sobre a proteção renal na unidade de terapia intensiva cirúrgica objetivou destacar os fatores de riscos peri-operatórios e discutir as atuais evidências científicas direcionadas para a diminuição da disfunção renal peri-operatória. CONTEÚDO: Apesar da baixa extração e adequada reserva renal de oxigênio, o rim é extremamente sensível

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Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose

Cited by 307 publications

References 26 publications

No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal Contrast Medium

No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal Contrast Medium

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

Proteção renal na unidade de terapia intensiva cirúrgica

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