[Aspects of acute renal failure during cardiovascular investigations and procedures which require the administration of iodine contrast medium. Literature review].
The increase in the number of diagnostic and interventional procedures in cardiovascular pathology brings with it more and more frequently the risk of impaired renal function due to the use of iodine contrast media. As these are often older patients with many cardiovascular risk factors, this risk is confounded by the general risk associated with these procedures. The evaluation of acutely impaired renal function in clinical practice is difficult because it essentially relies on the measurement of plasma creatinine or the calculation of its clearance, which are not perfect indicators and are also susceptible to errors of interpretation. The evaluation of the prognostic value of plasma creatinine variations is difficult because of the disparity of indications, procedures and patients. In all the available studies, and even accounting for their imperfections, this deterioration in renal function, even if transient, nevertheless seems to represent an important prognostic factor during the procedures and in the months that follow. Due to these restrictions, the evaluation of preventive measures for renal damage during diagnostic and interventional procedures is very imprecise, particularly as to the choice of contrast medium and the systematic use of certain pharmacological agents. Hydration, which would seem to be the easiest and most certain precaution, is not necessarily applicable in all cases, especially when left ventricular function is impaired.
Gayet
J L
JL
jeanlouisgayet@aol.com
D058186:Acute Kidney Injury / Q000139:chemically induced*; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D006801:Humans; D007455:Iodine / Q000009:adverse effects*; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers; D003287:Contrast Media; D007455:Iodine; D003404:Creatinine