Contrast-induced nephropathy.
Contrast-induced nephropathy (CIN) is a fairly common yet under-recognized clinical condition in the interventional cardiological practice. A 25% or more than 0.5 mg/dl rise of serum creatinine is generally accepted as defining CIN. The most important risk factors for CIN are pre-existing renal disease, volume of contrast media, nature of contrast media, and diabetes mellitus. Among the various postulated pathophysiological mechanisms for the precipitation of CIN, intra-renal vasoconstriction, and oxidative tubular injury are the best documented. Effective strategies to prevent CIN include adequate peri-procedural hydration with normal saline, use of N-acetylcysteine, keeping the volume of contrast media as low as feasible, and avoiding high-osmolal ionic contrast media. However, more efficient and cost-effective strategies are being developed and the search for the ideal contrast media is still on.
Ray
Saumitra
S
Vivekananda Institute of Medical Sciences, Kolkata, India. drsaumitra@yahoo.co.in
Dutta
Anjanlal
A
D003287:Contrast Media / Q000009:adverse effects*; D003401:Creatine / Q000097:blood; D004730:Endothelium, Vascular; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D009569:Nitric Oxide; D012307:Risk Factors; D014661:Vasoconstriction
D003287:Contrast Media; D009569:Nitric Oxide; D003401:Creatine