Contrast-induced nephropathy.
Contrast-induced nephropathy (CIN) is a well-recognized complication of radiographic contrast administration and is the third leading cause of hospital-acquired renal insufficiency. The use of contrast media is increasing, particularly in the area of endovascular therapy. Vascular interventionists need to be aware of strategies to reduce the risk of CIN. Numerous trials, meta-analyses, and expert guidelines for the prevention of CIN have been published between 1966 and 2006, but the majority of studies have been conducted on patients undergoing coronary interventions; few have involved vascular surgical population. The literature suggests that adequate hydration is essential in all patients due to receive contrast. No pharmacological agents have been shown to conclusively reduce the risk. Forced diuresis is harmful, and there is insufficient evidence to support routine use of hemodialysis or hemofiltration. Well conducted studies of other potential prophylactic techniques are needed in vascular populations.
Walsh
Stewart R
SR
Cambridge Vascular Research Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Tang
Tjun
T
Gaunt
Michael E
ME
Boyle
Jonathan R
JR
D001810:Blood Volume; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media / Q000009:adverse effects*; D006440:Hemofiltration; D006801:Humans; D017410:Practice Guidelines as Topic; D020011:Protective Agents / Q000627:therapeutic use; D015641:Radiography, Interventional / Q000009:adverse effects*; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D014656:Vascular Surgical Procedures
D003287:Contrast Media; D020011:Protective Agents