Prophylactic atorvastatin prior to intra-arterial administration of iodinated contrast media for prevention of contrast-induced acute kidney injury: A meta-analysis of randomized trial data

2019 ◽  
Vol 92 (3) ◽  
pp. 123-130 ◽  
Author(s):  
Yan-Yan Sun ◽  
Ling-Yun Liu ◽  
Tao Sun ◽  
Mei-Yan Wu ◽  
Fu-Zhe Ma
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Randomized Trial ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Trial Data ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

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.

Contrast-induced acute kidney injury in acute ischaemic stroke patients

2020 ◽  
pp. 197140092097720
Author(s):  
Catarina Brito ◽  
Luís Falcão ◽  
Mário Raimundo ◽  
Sara Fernandes ◽  
Adriana Fernandes ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Media Exposure ◽  
Kidney Injury ◽  
Iodinated Contrast Media ◽  
Stroke Patients ◽  
Stroke Imaging ◽  
Iodinated Contrast

Purpose The potential nephrotoxicity of intravenous iodinated contrast media is a major concern for acute ischaemic stroke imaging evaluation. This study aimed to assess the incidence of acute kidney injury after intravenous iodinated contrast media exposure in acute ischaemic stroke patients. Methods We conducted a retrospective cohort analysis between January 2012 and July 2018 to select adult patients admitted to the emergency department with acute ischaemic stroke. The exposed patients received a uniform intravenous dose of low osmolar non-ionic iodinated contrast media, as part of the imaging protocol for acute ischaemic stroke. The unexposed patients underwent a non-enhanced cranial computed tomography scan. Acute kidney injury was defined according to the Kidney Disease Improving Global Outcomes criteria, limited to the first 72 hours. Results A total of 161 and 105 patients were included in the exposed and unexposed groups, respectively. The median age was 72.8 years (interquartile range 20), 53% were men and 97% were white. Demographic and baseline characteristics were similar between the groups. The incidence of acute kidney injury between exposed ( n = 10, 6.2%) and unexposed ( n = 1, 1%) groups ( P = 0.073) was similar and contrast exposure was not a significant predictor of acute kidney injury. Conclusion Intravenous iodinated contrast media exposure during acute ischaemic stroke imaging protocols is not an independent predictor of acute kidney injury in patients with normal or near-normal renal function. Studies with larger sample sizes would help to clarify if patients with both cardiovascular risk factors and impaired renal function could benefit from prophylactic measures.

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