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 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.

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.

Acute Renal Failure Caused by Low-Osmolar Radiographic Contrast Media in Patients with Diabetic Nephropathy

1989 ◽  
Vol 23 (4) ◽  
pp. 315-317 ◽  
Author(s):  
Barbro Spångberg-Viklund ◽  
Tomas Nikonoff ◽  
Marc Lundberg ◽  
Rutger Larsson ◽  
Tommy Skau ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Diabetic Nephropathy ◽  
Contrast Media ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media

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.

Using Acetylcysteine to Prevent Radiographic-Contrast-Media-Induced Nephropathy in a Patient with Chronic Renal Failure

2001 ◽  
Vol 36 (7) ◽  
pp. 795-797
Author(s):  
Kevin E. Burns
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Serum Creatinine ◽  
Contrast Media ◽  
Stress Test ◽  
Chronic Hypertension ◽  
Baseline Serum ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media ◽  
History Of

Clinical Pearls Each of these special features conveys an idea, concept, or fact that may be useful in your pharmaceutical practice, but may not be widely known, published, or taught. An 84-year-old male with a history of chronic renal failure secondary to nephrectomy and chronic hypertension was admitted for elective coronary angiography following complaints of midsternal chest pain and an abnormal thallium stress test. The patient was found to have other risk factors for radiographic-contrast-media-induced nephropathy, including hyponatremia and hypoalbuminemia. Mild volume expansion was initiated and acetylcysteine 600 mg was administered orally every 12 hours on the day before the procedure. The patient's baseline serum creatinine was found to be 2 mg/dL. A total of 125 mL of nonionic, low-osmolality contrast media was infused during the procedure. An additional two doses of acetylcysteine 600 mg were administered on the day of the procedure. The patient's recovery was uneventful and he was discharged. The postprocedure serum creatinine was stable at 2 mg/dL 48 hours after the procedure. It appears that orally administered acetylcysteine can prevent radiographic-contrast-media-induced nephropathy.

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