scholarly journals Quercetin, a Promising Clinical Candidate for The Prevention of Contrast-Induced Nephropathy

2019 ◽  
Vol 20 (19) ◽  
pp. 4961 ◽  
Author(s):  
Laura Vicente-Vicente ◽  
David González-Calle ◽  
Alfredo Ginés Casanova ◽  
María Teresa Hernández-Sánchez ◽  
Marta Prieto ◽  
...  
Keyword(s):  
Contrast Media ◽  
Experimental Studies ◽  
High Dose ◽  
Preventive Strategy ◽  
Contrast Induced Nephropathy ◽  
Effective Prevention ◽  
Clinical Phase ◽  
Coronary Catheterization ◽  
Iodinated Contrast ◽  
Prophylactic Measures

Iodinated contrast media (CM) are the leading cause of acute renal failure of toxic origin. Between 21% and 50% of patients that receive them develop contrast-induced nephropathy (CIN). All prophylactic measures used so far have failed to provide effective prevention. Since oxidative stress is involved in the damage, a possible preventive strategy could be the administration of antioxidant substances, such as quercetin. This compound has shown renoprotective effects in experimental studies. The aim of this study was to evaluate whether quercetin may be helpful in preventing CIN in patients undergoing coronary catheterization. A clinical phase II study was conducted. Patients were distributed in two groups, namely, CM (patients who only received contrast media) and CM+Q (patients who were pretreated with quercetin orally for 3–5 days). Results showed less incidence of CIN in the CM+Q group, possibly due to glomerular protection, evidenced by a lower increase in serum creatinine and albuminuria; and a lower decrease in the glomerular filtration rate (GFR). Furthermore, in this group, the relative risk of developing CIN observed in patients that received a high dose of contrast media was inferior. In conclusion, this is the first study that demonstrates that quercetin is a promising safe candidate in preventing CIN.

scholarly journals Iodinated contrast medium: Is there a re(n)al problem? A clinical vignette-based review

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Karim Lakhal ◽  
Stephan Ehrmann ◽  
Vincent Robert-Edan
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Kidney Injury ◽  
Case Vignette ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast ◽  
Prophylactic Measures ◽  
Indirect Consequence ◽  
Toxic Potential

Abstract As we were taught, for decades, that iodinated contrast-induced acute kidney injury should be dreaded, considerable efforts were made to find out effective measures in mitigating the renal risk of iodinated contrast media. Imaging procedures were frequently either downgraded (unenhanced imaging) or deferred as clinicians felt that the renal risk pertaining to contrast administration outweighed the benefits of an enhanced imaging. However, could we have missed the point? Among the abundant literature about iodinated contrast-associated acute kidney injury, recent meaningful advances may help sort out facts from false beliefs. Hence, there is increasing evidence that the nephrotoxicity directly attributable to modern iodinated CM has been exaggerated. Failure to demonstrate a clear benefit from most of the tested prophylactic measures might be an indirect consequence. However, the toxic potential of iodinated contrast media is well established experimentally and should not be overlooked completely when making clinical decisions. We herein review these advances in disease and pathophysiologic understanding and the associated clinical crossroads through a typical case vignette in the critical care setting.

scholarly journals The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM)

BioMedicine ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 1 ◽  
Author(s):  
Jai-Sing Yang ◽  
Yan-Ru Peng ◽  
Shih-Chang Tsai ◽  
Yeu-Sheng Tyan ◽  
Chi-Cheng Lu ◽  
...  
Keyword(s):  
Contrast Media ◽  
Molecular Mechanism ◽  
In Vitro Studies ◽  
Iodinated Contrast Media ◽  
Contrast Induced Nephropathy ◽  
Iodinated Contrast

scholarly journals Contrast-Induced Nephropathy: Update on the Use of Crystalloids and Pharmacological Measures

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
D. Patschan ◽  
I. Buschmann ◽  
O. Ritter
Keyword(s):  
Contrast Media ◽  
Clinical Studies ◽  
Preventive Measures ◽  
Severe Complication ◽  
Iodinated Contrast Media ◽  
Preventive Strategies ◽  
Contrast Induced Nephropathy ◽  
The Past ◽  
Iodinated Contrast ◽  
Meta Analyses

Contrast-induced nephropathy (CIN) is a frequent and severe complication in subjects receiving iodinated contrast media for diagnostic or therapeutic purposes. Several preventive strategies were evaluated in the past. Recent clinical studies and meta-analyses delivered some new aspects on preventive measures used in the past and present. We will discuss all pharmacological and nonpharmacological procedures. Finally, we will suggest individualized recommendations for CIN prevention.

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.

Sign in / Sign up

Export Citation Format

Share Document