Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention
| Autor: | Richard Solomon, Michele Andreucci, Adis Tasanarong |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Radiographic contrast media Thyroid Gland Contrast Media lcsh:Medicine Renal function Review Article General Biochemistry Genetics and Molecular Biology Nephropathy Nephrotoxicity chemistry.chemical_compound Risk Factors Internal medicine Diabetes mellitus medicine Animals Humans Creatinine General Immunology and Microbiology business.industry lcsh:R General Medicine Hypoxia (medical) medicine.disease Surgery Radiography chemistry Itching Kidney Diseases medicine.symptom business |
| Zdroj: | BioMed Research International, Vol 2014 (2014) BioMed Research International |
| ISSN: | 2314-6141 2314-6133 |
| Popis: | Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given. |
| Databáze: | OpenAIRE |
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