Practical guide to prevention of contrast‐induced acute kidney injury after percutaneous coronary intervention
| Autor: | Antonio Colombo, Giulia Bugani, Antonio Mangieri, Paolo Cimaglia, Eleonora Gaudenzi, Francesco Gallo, Ilja Gardi, Andrea Fisicaro, Francesco Giannini, Alessandra Laricchia, Francesco Ponticelli |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous medicine.medical_treatment Psychological intervention Contrast Media 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Randomized controlled trial Iodinated contrast Risk Factors law medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Intensive care medicine business.industry Acute kidney injury Percutaneous coronary intervention General Medicine Acute Kidney Injury medicine.disease Treatment Outcome Conventional PCI Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Catheterization and Cardiovascular Interventions. 97:443-450 |
| ISSN: | 1522-726X 1522-1946 |
| DOI: | 10.1002/ccd.28740 |
| Popis: | Contrast-induced acute kidney injury (CI-AKI) represents a common but serious complication of percutaneous coronary interventions (PCI)-and in general of all those examinations requiring iodinated contrast injection-which affects not only renal function but also long-term prognosis. While several prophylactic approaches were designed in order to prevent CI-AKI, most failed to demonstrate clear benefits in randomized trials, and their implementation is therefore discouraged in clinical practice. The most notorious examples include pre-procedural bicarbonate or N-acetylcysteine, and preprocedural withdrawal of ACE inhibitors/Angiotensin receptor blockers. Those strategies that were instead demonstrated effective include the appropriate use of preprocedural hydration, reduction in contrast volume utilization, adoption of techniques for zero- or ultra-low-contrast procedures, and pharmacological treatments with statins. In this brief review, we summarize the main preventive strategies into brief and pragmatic recommendations designed to improve everyday clinical practice. |
| Databáze: | OpenAIRE |
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