Intravenous Contrast-Induced Nephropathy—The Rise and Fall of a Threatening Idea
| Autor: | Jonathan Steinman, Lyndon Luk, Jeffrey H. Newhouse |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pediatrics Contrast-induced nephropathy Contrast Media 030204 cardiovascular system & hematology Risk Assessment 030218 nuclear medicine & medical imaging Nephrotoxicity Nephropathy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Iodinated contrast Humans Medicine Creatinine business.industry Incidence (epidemiology) Angiocardiography Osmolar Concentration Acute kidney injury medicine.disease Control Groups female genital diseases and pregnancy complications Surgery chemistry Research Design Nephrology Administration Intravenous Kidney Diseases business Kidney disease |
| Zdroj: | Advances in Chronic Kidney Disease. 24:169-175 |
| ISSN: | 1548-5595 |
| Popis: | Contrast-induced nephropathy (CIN) has been considered to be a cause of renal failure for over 50 years, but careful review of past and recent studies reveals the risks of CIN to be overestimated. Older studies frequently cited the use of high-osmolality contrast media, which have since been replaced by low-osmolality contrast media, which have lower risks for nephropathy. In addition, literature regarding CIN typically describes the incidence following cardiac angiography, whereas the risk of CIN from intravenous injection is much lower. Most of the early published literature also lacked appropriate control groups to compare to those that received iodinated contrast, and thus attributed rises in creatinine to intravenous contrast without considering normal creatinine fluctuations (frequent in patients with kidney disease) and other acute pathologic states such as hypotension or nephrotoxic drug administration. The aim of this paper is to review the literature detailing CIN risk, discuss why CIN risk is often overestimated and how withholding contrast can lead to misdiagnosis and delay in appropriate patient management. |
| Databáze: | OpenAIRE |
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