Journal ArticleDOI
Contrast-induced nephropathy.
TLDR
The purpose of this study is to examine the pathophysiology, risk factors and clinical course of CIN, as well as the most recent studies dealing with its prevention and potential therapeutic interventions, especially during PCI.Abstract:
Radiological procedures utilizing intravascular iodinated contrast media are being widely applied for both diagnostic and therapeutic purposes and represent one of the main causes of contrast-induced nephropathy (CIN) and hospital-acquired renal failure. Although the risk of CIN is low (0.6–2.3 %) in the general population, it may be very high (up to 50 %) in selected subsets, especially in patients with major risk factors such as advanced chronic kidney disease and diabetes mellitus, and in those undergoing emergency percutaneous coronary interventions (PCI). Due to the lack of any effective treatment, prevention of this iatrogenic disease, which is associated with significant in-hospital and long-term morbidity and mortality and increased costs, is the key strategy. However, prevention of CIN continues to elude clinicians and is a main concern during PCI, as patients undergoing these procedures often have multiple comorbidities. The purpose of this study is to examine the pathophysiology, risk factors and clinical course of CIN, as well as the most recent studies dealing with its prevention and potential therapeutic interventions, especially during PCI.read more
Citations
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Journal ArticleDOI
2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA).
Steen Dalby Kristensen,Juhani Knuuti,Antti Saraste,Stefan D. Anker,Hans Erik Bøtker,Stefan De Hert,Ian Ford,José Ramón González-Juanatey,Bulent Gorenek,Guy R. Heyndrickx,Andreas Hoeft,Kurt Huber,Bernard Iung,Keld Kjeldsen,Dan Longrois,Thomas F. Lüscher,Luc Pierard,Stuart J. Pocock,Susanna Price,Marco Roffi,Per Anton Sirnes,Miguel Sousa-Uva,Vasilis Voudris,Christian Funck-Brentano +23 more
TL;DR: Clinicians will find the recommendations in these revised CPGs useful in their daily work and can be reassured that the recommendations have been vetted thoroughly by the most rigorous scientific process, so that cardiovascular clinicians worldwide may deliver optimal, standardized care.
Journal ArticleDOI
Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA)
Don Poldermans,Jeroen J. Bax,Eric Boersma,Stefan De Hert,Erik Eeckhout,Gerry Fowkes,Bulent Gorenek,Michael G. Hennerici,Bernard Iung,Malte Kelm,Keld Kjeldsen,Steen Dalby Kristensen,Jose Lopez-Sendon,Paolo Pelosi,François Philippe,Luc Pierard,Piotr Ponikowski,Jean-Paul Schmid,Olav F.M. Sellevold,Rosa Sicari,Greet Van den Berghe,Frank Vermassen +21 more
TL;DR: ESC Committee for Practice Guidelines (CPG): Alec Vahanian (Chairperson) (France), Angelo Auricchio (Switzerland), Jeroen J. Bax (The Netherlands), Claudio Ceconi (Italy) and Veronica Dean (France).
Journal ArticleDOI
Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention
TL;DR: It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration, and in high-risk patients N-acetylcysteine may also be given.
Journal ArticleDOI
Incidence of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Outpatient Setting
TL;DR: CIN occurs in >10% of patients who undergo CECT in the outpatient setting and is associated with a significant risk for severe renal failure and death.
Journal ArticleDOI
Perioperative acute kidney injury: risk factors, recognition, management, and outcomes
Emma Borthwick,Andrew Ferguson +1 more
TL;DR: Clinicians need to understand the risks and triggers for perioperative AKI, the association of even small transient rises in creatinine concentration with risk of death, and what actions they need to take promptly on diagnosis, to improve diagnosis and treatment.
References
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Journal ArticleDOI
A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: Development and initial validation
Roxana Mehran,Eve Aymong,Eugenia Nikolsky,Zoran Lasic,Ioannis Iakovou,Martin Fahy,Gary S. Mintz,Alexandra J. Lansky,Jeffrey W. Moses,Gregg W. Stone,Martin B. Leon,George Dangas +11 more
TL;DR: The risk of CIN after PCI can be simply assessed using readily available information and can be used for both clinical and investigational purposes.
Journal ArticleDOI
Incidence and Prognostic Importance of Acute Renal Failure After Percutaneous Coronary Intervention
Charanjit S. Rihal,Stephen C. Textor,Diane E. Grill,Peter B. Berger,Henry H. Ting,Patricia J.M. Best,Mandeep Singh,Malcolm R. Bell,Gregory W. Barsness,Verghese Mathew,Kirk N. Garratt,David R. Holmes +11 more
TL;DR: The overall incidence of ARF after PCI is low, and diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.
Journal ArticleDOI
The Effect of Acute Renal Failure on Mortality: A Cohort Analysis
TL;DR: Renal failure appears to increase the risk of developing severe nonrenal complications that lead to death and should not be regarded as a treatable complication of serious illness.
Journal ArticleDOI
Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty.
Christian Mueller,Gerd Buerkle,Heinz J. Buettner,Jens Petersen,André P. Perruchoud,Urs Eriksson,Stephan Marsch,Helmut Roskamm +7 more
TL;DR: Isotonic hydration is superior to half-isotonicHydration in the prevention of contrast media–associated nephropathy and three predefined subgroups benefited in particular from isotonic hydrations: women, persons with diabetes, and patients receiving 250 mL or more of contrast.
Journal ArticleDOI
Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction
Giancarlo Marenzi,Gianfranco Lauri,Emilio Assanelli,Jeness Campodonico,Monica De Metrio,Ivana Marana,Marco Grazi,Fabrizio Veglia,Antonio L. Bartorelli +8 more
TL;DR: Assessment of the incidence, clinical predictors, and outcome of contrast-induced nephropathy after primary percutaneous coronary intervention for acute myocardial infarction found that preventive strategies are needed, particularly in high-risk patients.