Prediction and prevention of contrast nephropathy.
Over the last 10 years, the main advances in RCN have come in our ability to predict outcomes for an individual patient. Treatment trials have been almost all uniformly disappointing. Recent positive trials with acetylcysteine and PGE1 will require confirmation in larger trials that are adequately powered for meaningful end points in the PCI population. In the meantime, adequate prehydration and maintenance of post-PCI urine flow rates of > 150 mL/min remain the most prudent measures. As the population ages, breakthroughs with respect to new contrast agents or effective prevention measures will be needed to offer PCI to the spectrum of patients at risk for renal injury.
McCullough
P A
PA
Cardiology Section, Department of Internal Medicine, University of Missouri-Kansas City, Truman Medical Center, 2301 Holmes St., Kansas City, MO 64108, USA. mcculloughp@umkc.edu
Manley
H J
HJ
D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D011237:Predictive Value of Tests
D003287:Contrast Media