Contrast-induced nephropathy: a review

Sanaei–Ardekani, Mohammad; Movahed, Mohammad Reza; Movafagh, Shahrzad; Ghahramani, Nasrollah

doi:10.1016/j.carrev.2005.07.004

Cited by 39 publications

(36 citation statements)

References 101 publications

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“…The overall incidence of CIN after PCI has been reported to be between 3.3 and 16.5% in different trials [6,7]. Chronic renal insufficiency, diabetes mellitus, age, contrast media volume, and recurrent administration are considered important risk factors for CIN: indeed, in high-risk patients or in patients with advanced kidney disease, its incidence increases up to 50% [8,9]. Different approaches for preventing CIN have been evaluated in patients undergoing elective and urgent PCI, with different results [10,11].…”

Section: Introductionmentioning

confidence: 97%

Use and efficacy of saline hydration and N-acetyl cysteine to prevent contrast-induced nephropathy in low-risk populations undergoing coronary artery angiography

et al. 2011

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Contrast-induced nephropathy (CIN) is most commonly defined as acute renal failure occurring within 48-72 h of exposure to an intravascular radiographic contrast medium that is not attributable to other causes. In the international literature, a 25% increase in serum creatinine levels or an increase in absolute values of 0.5 mg/dl from baseline has been suggested to define CIN. The reported incidence of CIN varies widely, ranging from 2 to 50%. This variability results from differences in the presence or absence of risk factors. With a retrospective analysis we evaluated the use of saline hydration plus N-acetyl cysteine (NAC) to prevent CIN in a low-risk population of patients undergoing coronary artery angiography compared with an historic low risk group not treated. From January 2009 to December 2009, 152 consecutive patients who underwent coronary artery angiography with a low osmolarity contrast agent were enrolled in our study, and compared with an historic control group consisting of 172 low-risk patients. Nephrotoxic drugs such as diuretics, ACE-I and ARBs were stopped at least 24 h before the procedure. Inclusion criteria to define low-risk population were the absence of: diabetes, age >65 years, or baseline creatinine >1.4 mg/dl. We have treated group A (152 patients, 47.3%) with a saline hydration (1 ml/kg/h) plus N-acetyl cysteine 600 mg 12 h before and 12 h after the procedure; group B (group control of 170 patients, 52.7%) were not treated. The overall incidence of CIN was 7.1% (23 patients). In particular, the incidence of CIN was 2.6% (4 patients) in the group A and 11.2% (19 patients) in the group B (p = 0.002). In the multivariate analysis, including risk factor such as age, hypertension, hypercholesterolemia, current smoking habit baseline creatinine level, contrast index and hydration, the last variable was the only one inversely correlated independently with the incidence of CIN (p = 0.001). In conclusion, intravenous hydration with saline and NAC is an effective and low cost tool in preventing CIN in patients undergoing coronary artery angiography, and, according to the current guidelines, should be used in all high-risk patients for CIN. Our results show that even in patients at low risk, hydration with saline 0.9% plus NAC is useful and significantly reduces the incidence of CIN.

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Section: Introductionmentioning

confidence: 97%

Use and efficacy of saline hydration and N-acetyl cysteine to prevent contrast-induced nephropathy in low-risk populations undergoing coronary artery angiography

et al. 2011

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“…Experimental studies have shown systemically delivered NAC reduces the permanent hearing loss associated with noise trauma, impulsive noise trauma and ototoxicity (summarized in ). The drug is currently used clinically, having been shown to reduce the incidence and severity of contrast-induced neuropathy (Sanaei-Ardekani et al, 2005;Schultz et al, 2006). It has also been used in clinical trials aimed at reducing reperfusion injury following knee surgery (Ege et al, 2006;Saricaoglu et al, 2005).…”

Section: Introductionmentioning

confidence: 98%

Permanent and transient effects of locally delivered n-acetyl cysteine in a guinea pig model of cochlear implantation

et al. 2010

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“…The definition of CIN used in the literature is a 25% elevation in the serum creatinine (Cr) level or an absolute Cr increase of 0.5 mg/dL (44 mol/L) 2-3 days after the procedure [3]. The most important risk factors are chronic renal insufficiency, diabetes mellitus (DM), age, contrast-medium volume, and recurrent administration [4]. A dose-dependent relationship can be found between contrast use and contrast-induced nephropathy [5,6].…”

Section: Discussionmentioning

confidence: 99%

Carotid stenting with low-dose contrast medium for patients with moderate-to-severe chronic renal insufficiency: Keyhole carotid stenting

Koçak

Kızılkılıç

Korkmazer

et al. 2013

European Journal of Radiology

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Contrast-induced nephropathy: a review

Cited by 39 publications

References 101 publications

Use and efficacy of saline hydration and N-acetyl cysteine to prevent contrast-induced nephropathy in low-risk populations undergoing coronary artery angiography

Use and efficacy of saline hydration and N-acetyl cysteine to prevent contrast-induced nephropathy in low-risk populations undergoing coronary artery angiography

Permanent and transient effects of locally delivered n-acetyl cysteine in a guinea pig model of cochlear implantation

Carotid stenting with low-dose contrast medium for patients with moderate-to-severe chronic renal insufficiency: Keyhole carotid stenting

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