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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.

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Citations
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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

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

Incidence and Prognostic Importance of Acute Renal Failure After Percutaneous Coronary Intervention

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.

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

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.
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