scholarly journals The Choice of the Iodinated Radiographic Contrast Media to Prevent Contrast-Induced Nephropathy

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Michele Andreucci ◽  
Teresa Faga ◽  
Antonio Pisani ◽  
Massimo Sabbatini ◽  
Domenico Russo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Kidney Injury ◽  
Prevention Measures ◽  
Intravascular Injection ◽  
Contrast Induced Nephropathy ◽  
Adequate Hydration ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media ◽  
Nephrotoxic Drugs

In patients with preexisting renal impairment, particularly those who are diabetic, the iodinated radiographic contrast media may cause contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI), that is, an acute renal failure (ARF), usually nonoliguric and asymptomatic, occurring 24 to 72 hours after their intravascular injection in the absence of an alternative aetiology. Radiographic contrast media have different osmolalities and viscosities. They have also a different nephrotoxicity. In order to prevent CIN, the least nephrotoxic contrast media should be chosen, at the lowest dosage possible. Other prevention measures should include discontinuation of potentially nephrotoxic drugs, adequate hydration with i.v. infusion of either normal saline or bicarbonate solution, and eventually use of antioxidants, such as N-acetylcysteine, and statins.

scholarly journals Prevention of Contrast-Induced Nephropathy through a Knowledge of Its Pathogenesis and Risk Factors

2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
Michele Andreucci ◽  
Teresa Faga ◽  
Antonio Pisani ◽  
Massimo Sabbatini ◽  
Domenico Russo ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Contrast Media ◽  
Contrast Induced Nephropathy ◽  
Iodinated Contrast ◽  
Adequate Hydration ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media ◽  
Nephrotoxic Drugs ◽  
Salt Depletion

Contrast-induced nephropathy (CIN) is an iatrogenic acute renal failure (ARF) occurring after the intravascular injection of iodinated radiographic contrast media. During the past several years, in many patients undergoing computed tomography, iodinated contrast media have not been used for the fear of ARF, thereby compromising the diagnostic procedure. But recent studies have demonstrated that CIN is rarely occurring in patients with normal renal function and that preexisting chronic renal failure and/or diabetes mellitus represent(s) predisposing condition(s) for its occurrence. After the description of CIN and its epidemiology and pathophysiology, underlying the important role played by dehydration and salt depletion, precautions for prevention of CIN are listed, suggested, and discussed. Maximum priority has to be given to adequate hydration and volume expansion prior to radiographic procedures. Other important precautions include the need for monitoring renal function before, during, and after contrast media injection, discontinuation of potentially nephrotoxic drugs, use of either iodixanol or iopamidol at the lowest dosage possible, and administration of antioxidants. A long list of references is provided that will enable readers a deep evaluation of the topic.

scholarly journals Radiographic Contrast-Media-Induced Acute Kidney Injury: Pathophysiology and Prophylactic Strategies

2013 ◽  
Vol 2013 ◽  
pp. 1-21 ◽  
Author(s):  
Umar Sadat
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Kidney Injury ◽  
Imaging Studies ◽  
Cardiovascular Medicine ◽  
Different Types ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media ◽  
Enhanced Imaging

Contrast-induced acute kidney injury (CI-AKI) is one of the most widely discussed and debated topics in cardiovascular medicine. With increasing number of contrast-media- (CM-) enhanced imaging studies being performed and growing octogenarian population with significant comorbidities, incidence of CI-AKI remains high. In this review, pathophysiology of CI-AKI, its relationship with different types of CM, role of serum and urinary biomarkers for diagnosing CI-AKI, and various prophylactic strategies used for nephroprotection against CI-AKI are discussed in detail.

scholarly journals Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

2014 ◽  
Vol 2014 ◽  
pp. 1-21 ◽  
Author(s):  
Michele Andreucci ◽  
Teresa Faga ◽  
Antonio Pisani ◽  
Massimo Sabbatini ◽  
Ashour Michael
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Contrast Media ◽  
Kidney Injury ◽  
Renal Medulla ◽  
No Production ◽  
Vascular Endothelial ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media ◽  
Do So

It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24–72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both.

scholarly journals THE INCIDENCE AND RISK FACTORS OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Pradeep Kurmi ◽  
Deepak Ameta ◽  
Chandra Bhanu Chandan
Keyword(s):  
Risk Factors ◽  
Contrast Media ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Absolute Increase ◽  
Increased Risk ◽  
Adequate Hydration

Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine  >1.5mg/dl] and increased contrast volume were associated with increased  risk of CIN whereas,  gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

scholarly journals Contrast-induced nephropathy and oxidative stress: mechanistic insights for better interventional approaches

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Prit Kusirisin ◽  
Siriporn C. Chattipakorn ◽  
Nipon Chattipakorn
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Contrast Media ◽  
Impaired Renal Function ◽  
Kidney Injury ◽  
Diagnostic Procedures ◽  
Volume Depletion ◽  
Contrast Induced Nephropathy ◽  
Stage Renal Disease ◽  
End Stage

Abstract Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an iatrogenic acute kidney injury observed after intravascular administration of contrast media for intravascular diagnostic procedures or therapeutic angiographic intervention. High risk patients including those with chronic kidney disease (CKD), diabetes mellitus with impaired renal function, congestive heart failure, intraarterial intervention, higher volume of contrast, volume depletion, old age, multiple myeloma, hypertension, and hyperuricemia had increased prevalence of CIN. Although CIN is reversible by itself, some patients suffer this condition without renal recovery leading to CKD or even end-stage renal disease which required long term renal replacement therapy. In addition, both CIN and CKD have been associated with increasing of mortality. Three pathophysiological mechanisms have been proposed including direct tubular toxicity, intrarenal vasoconstriction, and excessive production of reactive oxygen species (ROS), all of which lead to impaired renal function. Reports from basic and clinical studies showing potential preventive strategies for CIN pathophysiology including low- or iso-osmolar contrast media are summarized and discussed. In addition, reports on pharmacological interventions to reduce ROS and attenuate CIN are summarized, highlighting potential for use in clinical practice. Understanding this contributory mechanism could pave ways to improve therapeutic strategies in combating CIN.

scholarly journals Cardiac Catheterization Nurses Knowledge of Contrast-Induced Nephropathy: A Quality Improvement Project

2021 ◽  
Author(s):  
Brooke Maurice
Keyword(s):  
Risk Factors ◽  
Quality Improvement ◽  
Contrast Media ◽  
Kidney Failure ◽  
Educational Program ◽  
Quality Improvement Project ◽  
Contrast Induced Nephropathy ◽  
Improvement Project ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media

Contrast-induced nephropathy (CIN) is the development of acute kidney failure after radiographic contrast media administration. CIN is the third leading cause of hospital acquired kidney failure and is associated with increased risk for morbidity and mortality. Currently no treatment exists for CIN and only supportive care is provided with the anticipation renal function will resolve eventually. Cardiac angiogram or catheterization is one of the most commonly performed procedures with an average of 2 million cases annually. Cardiac catheterizations require large amounts of radiographic contrast media placing patients at risk for the development of CIN. Prevention of CIN is key and requires early identification of risk factors, timely precautions and patient education, which is conducted largely by nursing staff. For this quality improvement project, an informal needs assessment was conducted within the cardiac catherization laboratory at Landmark Medical Center which identified nurse’s had limited knowledge of CIN. All staff nurses in the cardiac catheterization laboratory were invited to participate in an education seminar on CIN. A pretest, educational program, posttest design was used to identify change in nurse’ knowledge of CIN. Nine out of eleven nurses (82%) participated in the educational seminar, completed the pretest and posttest. The posttest scores had a 51-percentage point increase and every posttest question improved in comparison to the pretest. Findings from this quality improvement project suggest that nurses’ ability to recognize CIN risk factors and knowledge of preventative strategies increased significantly after participation in an educational program.

scholarly journals Nonpharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Paweena Susantitaphong ◽  
Somchai Eiam-Ong
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Kidney Injury ◽  
Minimum Volume ◽  
Routine Identification ◽  
Risk Patients ◽  
Nephrotoxic Drugs ◽  
Hospital Acquired ◽  
Functioning Kidney ◽  
Selection Of

Contrast-induced AKI (CI-AKI) has been one of the leading causes for hospital-acquired AKI and is associated with independent risk for adverse clinical outcomes including morbidity and mortality. The aim of this review is to provide a brief summary of the studies that focus on nonpharmacological strategies to prevent CI-AKI, including routine identification of at-risk patients, use of appropriate hydration regimens, withdrawal of nephrotoxic drugs, selection of low-osmolar contrast media or isoosmolar contrast media, and using the minimum volume of contrast media as possible. There is no need to schedule dialysis in relation to injection of contrast media or injection of contrast agent in relation to dialysis program. Hemodialysis cannot protect the poorly functioning kidney against CI-AKI.

Adverse Drug Reactions to Radiographic Contrast Media in a Teaching Hospital in North India: An Observational Study

2019 ◽  
Vol 14 (2) ◽  
pp. 122-126
Author(s):  
Deepti Chopra ◽  
Abhinav Jain ◽  
Richa Garg ◽  
Shreya Dhingra
Keyword(s):  
Observational Study ◽  
Contrast Media ◽  
Adverse Drug Reactions ◽  
Teaching Hospital ◽  
Adverse Reactions ◽  
North India ◽  
Drug Reactions ◽  
Iodinated Contrast ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media

Background: Radiocontrast media are used extensively nowadays to visualize internal organs. Currently, non-ionic iodinated contrast media are used which are generally considered to be safe but some adverse reactions have been reported. Thus, the present study was carried out to analyze the nature and incidence of adverse drug reactions (ADRs) to radiographic contrast media in a teaching hospital. Methods:An observational study carried out for a period of six months in a teaching hospital. Contrast media induced adverse reactions were analyzed in terms of affected organs, rate, causality assessment, severity and preventability. The treatment and outcomes of adverse events were also recorded. Naranjo Probability Scale was used to evaluate the relationship between the contrast agent used and the suspected ADR. The severity of the suspected ADRs was determined using Hartwig Scale and preventability was assessed using modified Schumock and Thornton criterion. Results:A total of 15 suspected ADRs occurred in 11 patients with an incidence of 1.4%. It included 5 (45.4%) males and 6 (54.5%) females (p < 05). The highest percentage (72.7 %) of ADRs was seen in adult patients, the mean age being 40.8 years. Vomiting (33.3%) was the most common ADR noted followed by severe nausea and rashes. 64.7 % of ADRs were categorized as probable and 35.3 % were possible. Adverse reactions required treatment in 46.6% patients. There was no fatality reported. Conclusion:The reactions observed were mild to moderate in severity and occurred within 30 minutes of the administration of the contrast.

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