Contrast nephropathy.
Contrast nephropathy will increase mortality up to 30% following angiographic procedures. Before performing such procedures a careful reassessment of the risk/benefit ratio should be performed. Mannitol and diuretics play no role in prevention. Hydration and correction of abnormal electrolyte levels should be done in all patients. Pre-treatment with acetylcysteine and theophylline is a well-accepted strategy and should always be utilized. If creatinine levels are above 2.5 to 3 mg/dl, fenoldopam may provide additional protection, particularly in diabetic patients. However, the role of fenoldopam is controversial. Prophylactic hemodialysis may prove to be an additional tool in the fight against this disease in selected patients.
Rezkalla
Shereif H
SH
Department of Cardiology, Marshfield Clinic, Marshfield, Wisconsin 54449, USA. rezkalla.shereif@marshfieldclinic.org
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D000792:Angiography; D003287:Contrast Media / Q000009:adverse effects*; D018818:Fenoldopam / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D012307:Risk Factors
D003287:Contrast Media; D018818:Fenoldopam