Contrast Media—Different Types of Contrast Media, Their History, Chemical Properties, and Relative Nephrotoxicity

Lohani, Sadichhya; Rudnick, Michael R.

doi:10.1016/j.iccl.2020.02.008

Cited by 8 publications

(8 citation statements)

References 89 publications

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“…The amount of CM volume used during the procedure or the amount of body weight-adapted CM seems to be the most valuable parameter in predicting the development of CI-AKI, but in some cases the development of CI-AKI cannot be explained by the amount of CM volume. 25,26 Therefore, clinicians continue to search for parameters that predict the development of CI-AKI. 27 In the normal renal system, urine formation depends on the net filtration pressure which is difference between arterial pressure and venous system pressure.…”

Section: Discussionmentioning

confidence: 99%

A Novel Risk Assessment Model Using Urinary System Contrast Blush Grading to Predict Contrast-Induced Acute Kidney Injury in Low-Risk Profile Patients

Efe

Keskin²,

Toprak³

et al. 2021

Angiology

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Contrast-induced acute kidney injury (CI-AKI) can occur after coronary interventions despite protective measures. We evaluated the effect of urinary system contrast blush grading for predicting post-procedure CI-AKI in 486 patients with chronic coronary artery disease. Patient characteristics and blood samples were collected. Urinary system contrast blush grade was recorded during the coronary angiography and interventions. Post-procedure third to fourth day blood samples were collected for diagnosis of CI-AKI. The median age of the patients was 61 years (53-70, interquartile range), and 194 (39.9%) participants were female. Contrast-induced acute kidney injury occurred in 78 (16%) patients. By comparing full and reduced models with the likelihood ratio test, it was observed that in the reduced model, factors such as age, diabetes mellitus, body weight–adapted contrast media (CM), hemoglobin, and urinary system blush were associated with CI-AKI presence. The probability of CI-AKI presence increased slightly from grade 0 to 1 blush, but it increased sharply grade from 1 to 2 blush. According to our results, an increase in body weight–adapted CM and urinary blush grading were the main predictors of CI-AKI. These findings suggest that when body weight–adapted CM ratio exceeds 3.5 mL/kg and urinary contrast blush reaches grade 2, the patients should be followed up more carefully for the development of CI-AKI.

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Section: Discussionmentioning

confidence: 99%

A Novel Risk Assessment Model Using Urinary System Contrast Blush Grading to Predict Contrast-Induced Acute Kidney Injury in Low-Risk Profile Patients

Efe

Keskin²,

Toprak³

et al. 2021

Angiology

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“…26 Over the past two decades, there have been advances in preventive interventions for contrast-induced AKI (e.g., lower volumes of less nephrotoxic contrast, isotonic intravenous fluid), data suggesting that the risk of AKI related to contrast may be overstated and updated clinical practice guidelines that recommend the use of validated risk prediction tools to stratify patients on the appropriateness of invasive care. 7,8,[27][28][29][30][31][32] Accordingly, it is essential to understand whether, in contemporary practice, patients with CKD are less likely to receive clinically indicated invasive care to treat ACS compared with those without CKD. This is of critical importance because cardiovascular disease remains the leading cause of death in patients with CKD, and empirical evidence suggests that the use of invasive care in patients with ACS and CKD is associated with lower mortality.…”

Section: Introductionmentioning

confidence: 99%

Utilization and Outcomes of Clinically Indicated Invasive Cardiac Care in Veterans with Acute Coronary Syndrome and Chronic Kidney Disease

Weisbord

Mor

Hochheiser

et al. 2023

JASN

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Background Previous studies have shown that patients with CKD are less likely than those without CKD to receive invasive care to treat acute coronary syndrome (ACS). However, few studies have accounted for whether such care was clinically indicated or assessed whether nonuse of such care was associated with adverse health outcomes. Methods We conducted a retrospective cohort study of US veterans who were hospitalized at Veterans Affairs Medical Centers from January 2013 through December 2017 and received a discharge diagnosis of ACS. We used multivariable logistic regression to investigate the association of CKD with use of invasive care (coronary angiography, with or without revascularization; coronary artery bypass graft surgery; or both) deemed clinically indicated based on Global Registry of Acute Coronary Events 2.0 risk scores that denoted a 6-month predicted all-cause mortality ≥5%. Using propensity scoring and inverse probability weighting, we examined the association of nonuse of clinically indicated invasive care with 6-month all-cause mortality. Results Among 34,430 patients with a clinical indication for invasive care, the 18,780 patients with CKD were less likely than the 15,650 without CKD to receive such care (adjusted odds ratio, 0.68; 95% confidence interval, 0.65 to 0.72). Among patients with CKD, nonuse of invasive care was associated with higher risk of 6-month all-cause mortality (absolute risk, 21.5% versus 15.5%; absolute risk difference 6.0%; adjusted risk ratio, 1.39; 95% confidence interval, 1.29 to 1.49). Findings were consistent across multiple sensitivity analyses. Conclusions In contemporary practice, veterans with CKD who experience ACS are less likely than those without CKD to receive clinically indicated invasive cardiac care. Nonuse of such care is associated with increased mortality.

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“…The mechanism of CI-AKI remains unclear. At present, it is believed that its occurrence is closely related to contrast agent nephrotoxicity [ 5 , 6 ]. It includes renal hemodynamic changes, renal tubular toxic injury, inflammatory response, oxidative stress, and apoptosis [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Rosiglitazone Alleviates Contrast-Induced Acute Kidney Injury in Rats via the PPARγ/NLRP3 Signaling Pathway

Huang

Chen

et al. 2022

Disease Markers

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Background. This study investigated the effect and mechanism of rosiglitazone on a rat model with contrast-induced acute kidney injury (CI-AKI). Materials and Methods. The CI-AKI rat model was established from Sprague Dawley rats by furosemide injection (10 ml/kg) to the caudal vein followed by iohexol (11.7 ml/kg). The experimental grouping was randomly allocated into control, model, rosiglitazone, and T0070907 groups. Blood samples were collected from the abdominal aorta. Serum creatinine, urea nitrogen, MDA, and SOD contents were detected by biochemical analysis. TNF-α and IL-10 expression was detected by ELISA. Urine creatinine and urine protein were measured following 24-h urine biochemistry testing. Cell pathology and apoptosis were detected by H&E and TUNEL staining, respectively. PPARγ, NLRP3, eNOS, and caspase-3 mRNA expression were detected by qPCR. Caspase-3 and NLRP3 expression were detected by immunohistochemistry. Results. The CI-AKI rat model was successfully established because the results showed that compared with control, serum creatinine, urea nitrogen, MDA, SOD, TNF-α, and IL-10, urine creatinine and urine protein levels were significantly increased in the model group, indicating AKI, but was significantly decreased with rosiglitazone treatment, indicating recovery from injury, while opposite results were obtained with SOD. Apoptosis rate was significantly increased in the model group and significantly decreased with rosiglitazone treatment. NLRP3 and eNOS increased significantly in the model group and decreased significantly with rosiglitazone treatment, while opposite results were obtained with PPARγ. NLRP3 and caspase-3 protein expression was significantly increased in the model group and significantly decreased with rosiglitazone treatment. Conclusion. Rosiglitazone could alleviate acute renal injury in the CI-AKI rat model by regulating the PPARγ/NLRP3 signaling pathway and should be further investigated as a potential treatment in clinical studies.

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Contrast Media—Different Types of Contrast Media, Their History, Chemical Properties, and Relative Nephrotoxicity

Cited by 8 publications

References 89 publications

A Novel Risk Assessment Model Using Urinary System Contrast Blush Grading to Predict Contrast-Induced Acute Kidney Injury in Low-Risk Profile Patients

A Novel Risk Assessment Model Using Urinary System Contrast Blush Grading to Predict Contrast-Induced Acute Kidney Injury in Low-Risk Profile Patients

Utilization and Outcomes of Clinically Indicated Invasive Cardiac Care in Veterans with Acute Coronary Syndrome and Chronic Kidney Disease

Rosiglitazone Alleviates Contrast-Induced Acute Kidney Injury in Rats via the PPARγ/NLRP3 Signaling Pathway

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