Contrast-induced nephropathy: a review.
Contrast-induced nephropathy (CIN) is one of the leading causes of renal impairment in the United States and the third cause of hospital-acquired renal failure. Reduction in the incidence of CIN can lead to a decrease in the morbidity, mortality, and length of hospital stay. Although prophylactic hydration has been promising in decreasing the occurrence of CIN, other efforts such as diuretics, calcium channel blockers, theophylline, aminophylline, atrial natriuretic peptide, dopamine, and fenoldopam have been disappointing. The preventive effect of N-acetylcysteine on CIN has not been consistent in the literature. In a recent clinical trial, bicarbonate infusion was more effective than hydration in the prevention of CIN. Mechanical devices are in development to perfuse renal arteries with protective drugs during contrast exposure or for removal of contrast from coronary sinus during coronary angiography. In this article, we have reviewed available data in regards to CIN.
Sanaei-Ardekani
Mohammad
M
Department of Internal Medicine, Washington Hospital Center, Georgetown University, Washington, DC 20010, USA. ssanaei@hotmail.com
Movahed
Mohammad-Reza
MR
Movafagh
Shahrzad
S
Ghahramani
Nasrollah
N
D000111:Acetylcysteine / Q000627:therapeutic use; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control; D003287:Contrast Media / Q000009:adverse effects*; D005440:Fluid Therapy / Q000379:methods; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D017693:Sodium Bicarbonate / Q000627:therapeutic use
D003287:Contrast Media; D016166:Free Radical Scavengers; D017693:Sodium Bicarbonate; D000111:Acetylcysteine