Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL): A Randomized Comparison of 3 Preventive Strategies

Briguori, Carlo; Airoldi, Flavio; D’Andrea, Davide

doi:10.1016/j.jvs.2007.10.028

Cited by 107 publications

(201 citation statements)

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“…The incidence of CIN was recorded on an intent-to-treat basis. Patients in additional treatment arms evaluating other putative preventive agents, such as N-acetylcysteine [7] and ascorbate [5], were excluded. Due to the relatively small number of pertinent trials, analysis on the impact of study-, patient-or treatmentrelated variables was not deemed feasible, and accordingly data for those variables were not extracted.…”

Section: Methodsmentioning

confidence: 99%

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Prävention der kontrastmittelinduzierten Nephropathie mit isotonem Natriumbikarbonat: eine Meta-Analyse

Joannidis

Schmid

Wiedermann

2008

Wien Klin Wochenschr

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Section: Methodsmentioning

confidence: 99%

“…A randomized trial carried out in 2004 demonstrated the effectiveness of bicarbonate in the prevention of CIN in 137 patients [4]. This result was confirmed by four additional randomized trials reported in 2007 [5][6][7][8]. However, in four recent trials no significant treatment benefit of bicarbonate was evident [9][10][11][12].…”

Section: Introductionmentioning

confidence: 92%

Prävention der kontrastmittelinduzierten Nephropathie mit isotonem Natriumbikarbonat: eine Meta-Analyse

Joannidis

Schmid

Wiedermann

2008

Wien Klin Wochenschr

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“…For most of the drugs tested, including fenoldopam, dopamine, calcium channel blockers, atrial natriuretic peptide, L-arginine, prostaglandin E 1 , furosemide, mannitol and endothelin receptor antagonist [70,72,[87][88][89][90], the evidence is limited, conflicting or even negative. Some drugs that appear potentially beneficial, such as theophylline/aminophylline, statins, ascorbic acid and iloprost [72,[91][92][93][94][95][96][97][98][99][100][101], require further evaluation. None of these drugs was consistently effective, and some of them (e.g.…”

Section: Prophylactic Strategiesmentioning

confidence: 99%

Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines

et al. 2011

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Topics reviewed include the definition of CIN, the choice of contrast medium, the prophylactic measures used to reduce the incidence of CIN, and the management of patients receiving metformin. Key Points • Definition, risk factors and prevention of contrast medium induced nephropathy are reviewed. • CIN risk is lower with intravenous than intra-arterial iodinated contrast medium. • eGFR of 45 ml/min/1.73 m (2) is CIN risk threshold for intravenous contrast medium. • Hydration with either saline or sodium bicarbonate reduces CIN incidence. • Patients with eGFR ≥ 60 ml/min/1.73 m (2) receiving contrast medium can continue metformin normally.

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“…Equivocal results have been reported for NAC (see above discussion), ascorbic acid [97,98], fenoldapam [99,100], dopamine [101][102][103][104] , calcium channel blockers [105][106][107], atrial natriuretic peptide [103,108], L-arginine [109], and statins [110][111][112]. Agents that clearly are not protective and may be harmful include furosemide [68,113], mannitol [68,103,114], and endothelin receptor antagonists [115].…”

Section: Other Pharmacologic Protective Strategiesmentioning

confidence: 99%

Contrast-induced nephropathy: pathogenesis and prevention

Cronin

2010

Pediatr Nephrol

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Contrast-induced nephropathy (CIN) is the third most common cause of acute kidney injury in hospitalized patients. Diagnostic and interventional cardiovascular procedures generate nearly half the cases. Elderly patients and those with chronic kidney disease, diabetes, and cardiovascular disease are at greatest risk. Procedure-related risk factors include large volumes of contrast and agents with a high osmolality. Renal medullary ischemia arising from an imbalance of local vasoconstrictive and vasodilatory influences coupled with increased demand for oxygen-driven sodium transport may be the key to its pathogenesis. Contrast agents may also have a direct cytotoxic effect that operates through the generation of reactive oxygen species. Pre- and post-procedure administration of normal saline, isotonic sodium bicarbonate, N-acetylcysteine, and a variety of other pharmacologic agents have been used to prevent or mitigate CIN. While normal saline is generally accepted as protective against CIN, uncertainty still surrounds the role of sodium bicarbonate and N-acetylcysteine. Dialytic therapies before, during, and after exposure to contrast have been tested with mixed results. Logistical and economic disincentives argue against these modalities.

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Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL): A Randomized Comparison of 3 Preventive Strategies

Cited by 107 publications

References 0 publications

Prävention der kontrastmittelinduzierten Nephropathie mit isotonem Natriumbikarbonat: eine Meta-Analyse

Prävention der kontrastmittelinduzierten Nephropathie mit isotonem Natriumbikarbonat: eine Meta-Analyse

Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines

Contrast-induced nephropathy: pathogenesis and prevention

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