title: [Contrast-induced nephropathy: the VIKISAFE study group statement].
abstract: Contrast-induced nephropathy (CIN) has undergone a significant evolution over the years in terms of epidemiology and diagnostic criteria. At present it is defined as CI-AKI (contrast-induced acute kidney injury) and represents a pathologically relevant event for different disciplines. Thus, a multidisciplinary approach is needed to propose and deploy a common strategy to reduce the incidence of CI-AKI. It seems that the use of isoosmolar non-ionic contrast media such as iodixanol can reduce the nephrotoxic effects. However, since these - still controversial - results have been obtained using various diagnostic criteria, they are difficult to compare and pool together. Common criteria are therefore required. The term acute renal failure has been replaced by acute kidney injury (AKI). Thanks to consensus groups such as ADQI (Acute Dialysis Quality Initiative) and AKIN (Acute Kidney Injury Network) and the development of guidelines by KDIGO, the diagnostic criteria for AKI are well defined. Nevertheless, the possibility to utilize new biomarkers of structural kidney damage such as neutrophil gelatinase-associated lipocalin (NGAL) or cystatin C has introduced the concept that AKI may be diagnosed even in the absence of creatinine elevation or decreased urine output. A re-evaluation of the epidemiology of CI-AKI based on new diagnostic criteria is required. In this paper the results of a collaborative multidisciplinary study group are reported from the perspective of different disciplines including nephrology, cardiology, radiology and pharmacology. The findings in a cohort of cardiac patients undergoing imaging procedures using exclusively the isoosmolar non-ionic contrast medium iodixanol are evaluated according to the RIFLE/AKIN criteria.
authors.affiliation: Dipartimento di Nefrologia, Dialisi e Trapianto Renale, Ospedale San Bortolo, Vicenza, Italy. cronco@goldnet.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Mauro
authors.initials: M
authors.lastname: Maioli
authors.forename: Vito
authors.initials: V
authors.lastname: Lorusso
authors.forename: Dinna N
authors.initials: DN
authors.lastname: Cruz
authors.forename: Fulvio
authors.initials: F
authors.lastname: Stacul
mesh_terms: D003287:Contrast Media / Q000009:adverse effects* / Q000494:pharmacology / Q000633:toxicity; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol