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 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 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 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 Contrast-associated acute kidney injury in patients with arterial hypertension and stable coronary artery disease

2020 ◽  
Vol 17 (3) ◽  
pp. 48-52
Author(s):  
Olga Iu. Mironova ◽  
Viktor V. Fomin
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Contrast Media ◽  
Stable Coronary Artery Disease ◽  
Kidney Injury ◽  
Baseline Creatinine ◽  
Artery Disease

Relevance.The combination of stable coronary artery disease (CAD) and arterial hypertension (AH) is one of the most common seen by cardiologists. The administration of contrast media might increase the risk of development of acute kidney injury, especially in patients with comorbidities. The influence of iodine contrast media administration on the risk of development of contrast-associated acute kidney injury (CA-AKI) in patients with stable CAD and AH was studied in our work. Materials and methods.863 patients with stable CAD and AH and indications for interventions requiring intraarterial administration of contrast media were included in the prospective open observational cohort study (ClinicalTrials.gov ID NCT04014153). CA-AKI was defined according to KDIGO criteria as the elevation of serum creatinine 25% and more above baseline or 0.5 mg/dl (44 mkmol/l) and more in 48 hours after intraarterial administration of contrast media. The primary endpoint was the development of CA-AKI. Results.Diabetes mellitus, obesity and hyperuricemia were not statistically significant risk factors of CA-AKI development according to the contingency tables analyses, unlike proteinuria. A logistic regression model was built (area under the curve 0.7638,p0.0001, 95% confidence interval 0.7130.815) and included the following risk factors: age, weight, body mass index, female gender, heart failure, proteinuria, AH, anemia, baseline creatinine. Proteinuria, baseline creatinine and contrast volume were statistically significant ones. Conclusion.The rate of CA-AKI was 12.6%. Proteinuria, baseline creatinine and contrast volume were statistically significant risk factors of CA-AKI in logistic regression model. Key words:contrast-induced acute kidney injury, contrast-induced nephropathy, contrast-associated acute kidney injury, coronary artery disease, percutaneous coronary intervention, arterial hypertension, stable coronary artery disease, prognosis.

Acute kidney injury in preterm neonates with ≤30 weeks of gestational age and its risk factors

2019 ◽  
Vol 71 (5) ◽  
Author(s):  
Rita Ladeiras ◽  
Filipa Flor-De-Lima ◽  
Henrique Soares ◽  
Bárbara Oliveira ◽  
Hercília Guimarães
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Gestational Age ◽  
Kidney Injury ◽  
Preterm Neonates

KIDNEY INJURY IN CANCER THERAPY

2018 ◽  
Vol 22 (5) ◽  
pp. 17-24 ◽  
Author(s):  
E. V. Burnasheva ◽  
Y. V. Shatokhin ◽  
I. V. Snezhko ◽  
A. A. Matsuga
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Cytotoxic Effect ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Chemotherapeutic Agents ◽  
Oxygen Intermediates ◽  
Circulating Blood Volume

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular  injury, nephrotoxic drugs including chemotherapeutic agents. Also  bone marrow transplantation complications, infections with immune  suppression (including septicemia), tumor lysis syndrome should be  taken into account. Chemotherapeutic agents are a common cause  of acute kidney injury but can potentially lead to chronic kidney  disease development in cancer patients. This article summarizes risk  factors of acute kidney injury in cancer patients. Risk factors are  divided into two groups. The systemic are decrease of total  circulating blood volume, infiltration of kidney tissue by tumor cells,  dysproteinemia, electrolyte disturbances. The local (renal) risk  factors are microcirculation disturbances, drugs biotransformation  with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its  sensitivity to ischemia. Drug-related risk factors include: drugs  combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular  precipitates. Early diagnosis, timely prevention and treatment of  these complications provide significantly improve nononcologic results of treatment.

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