[Assessment of renal function, iatrogenic hyperkalemia and acute renal dysfunction in cardiology. Contrast-induced nephropathy].
Renal impairment influences the prognosis of patients with cardiovascular disease and increases cardiovascular risk. Renal dysfunction is a marker of lesions in other parts of the vascular tree and detection facilitates early identification of individuals at high risk of cardiovascular events. In patients with cardiovascular disease, renal function is assessed by measuring albuminuria in a spot urine sample and by estimating the glomerular filtration rate using creatinine-derived predictive formulas or equations. We recommend the Chronic Kidney Disease Epidemiology Collaboration or the Modification of Diet in Renal Disease formulas. The Cockcroft-Gault formula is a possible alternative. The administration of drugs that block the angiotensin-renin system can, on occasion, be associated with acute renal dysfunction or hyperkalemia. We need to know when risk of these complications exists so as to provide the best possible treatment: prevention. Given the growing number of diagnostic and therapeutic procedures in the field of cardiology that use intravenous contrast media, contrast-induced nephrotoxicity represents a significant problem. We should identify the risk factors and patients at greatest risk, and prevent it from appearing.
Servicio de Nefrología, Hospital Universitario Dr. Peset, Valencia, España. jlgorriz@senefro.org
José Luis
JL
Górriz Teruel
Sandra
S
Beltrán Catalán
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology*; D000419:Albuminuria / Q000175:diagnosis; D002309:Cardiology / Q000379:methods*; D003287:Contrast Media / Q000009:adverse effects*; D005682:Gadolinium / Q000009:adverse effects; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D006947:Hyperkalemia / Q000175:diagnosis* / Q000209:etiology*; D007049:Iatrogenic Disease; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D012079:Renal Circulation / Q000502:physiology; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D012307:Risk Factors; D040242:Risk Reduction Behavior
D003287:Contrast Media; D005682:Gadolinium