Contrast media induced nephropathy: A literature review of the available evidence and recommendations for practice

Deek, Hiba; Newton, Phillip J.; Sheerin, Noella; Noureddine, Samar; Davidson, Patricia M.

doi:10.1016/j.aucc.2013.12.002

Cited by 23 publications

(20 citation statements)

References 60 publications

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“…The reported incidence of CIN is variable, depending on the study definitions employed and underlying risk factors, and ranges from 5% to 30% overall. [5][6][7][8]18,19] Recent observational studies have reported low rates of CIN among hospitalised patients. [20,21] ShamsEddin Taher [21] observed a 11.5% rate of CIN in patients undergoing percutaneous intervention (PCI) while Selistre et al [20] reported a 14% incidence of CIN in patients undergoing contrast CT administration in Brazil.…”

Section: Survived N=48mentioning

confidence: 99%

“…[1][2][3][4] The rates of CIN vary, depending on the study definitions employed and underlying risk factors, and range from 0.6% to 30% or higher among risk groups. [5][6][7][8] CIN is also associated with increased duration of hospitalisation and early and late mortality. In-hospital mortality due to CIN ranges from 7% to 22%.…”

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confidence: 99%

“…[5][6][7][8] CIN is also associated with increased duration of hospitalisation and early and late mortality. In-hospital mortality due to CIN ranges from 7% to 22%.…”

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Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

et al. 2016

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Despite preventive guidelines, iatrogenic contrast-induced nephropathy (CIN) ranks third as a cause of hospital-acquired AKI, impacts significantly on morbidity and mortality, and is associated with longer stays in hospitals, with higher medical costs. [1][2][3][4] The rates of CIN vary, depending on the study definitions employed and underlying risk factors, and range from 0.6% to 30% or higher among risk groups. [5][6][7][8] CIN is also associated with increased duration of hospitalisation and early and late mortality. In-hospital mortality due to CIN ranges from 7% to 22%. [9] McCullough et al. [9] reported early mortality of 1.1% in controls, 7.1% in CIN patients, and 35% in CIN patients that required dialysis. Owing to increased comorbidities, hospitalised patients have increased risk for developing CIN compared with ambulatory patients .[10]Inflammation and endothelial dysfunction, together with reactive oxygen species (ROS), are implicated in the pathogenesis of CIN. [8] Iodinated contrast media directly injures the renal tubular epithelium by producing ROS radicals that cause intra-renal vasoconstriction leading to ischaemia and death of tubular cells. [8,10,11] Serum albumin is an important antioxidant that reduces the formation of oxygen free radicals and is important in expanding intravascular volume. [12,13] However, the role of serum albumin in reducing the incidence of CIN remains unexplored.Sub-Saharan Africa has a dearth of data on rates of CIN. This study investigated the rates of CIN together with the influence of serum albumin, albuminuria, age, haemoglobin, and glomerular filtration rate (GFR) levels on CIN and patient outcomes. Methods Study design, setting and populationThis study was a prospective observational study conducted at Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa, from 1 July 2014 to 30 July 2015. Ethical approval was obtained from the human research ethics committee (HREC) of the University of the Witwatersrand and informed written consent was obtained from all patients. We consecutively recruited hospitalised patients undergoing computed tomography (CT) and angiography from the Divisions of Radiology and Cardiology, respectively. The following exclusion criteria were used: <18 years of age; evidence of pre-existing AKI (clinical or laboratory); end-stage renal disease (ESRD); renal replacement therapy (RRT); prior contrast media administration in the preceding 7 days; pregnancy; or incomplete data. Study proceduresThe study physician reviewed participants' medical records and examined the participants in order to determine pre-existing risk factors for CIN. The medical records were reviewed to determine patient duration of hospitalisation, dialysis requirements and mortality. Study phlebotomists collected blood samples prior to and post contrast media administration. Pre contrast, urine was collected and analysed for microalbuminuria using the Chemistrip Micral 30 immune assay test (Roche 11544039172). Serum creatinine was analysed using the Jaff...

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Section: Survived N=48mentioning

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Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

et al. 2016

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“…4 The Canadian Association of Radiologists (CAR) published consensus guidelines in 2012 regarding the prevention of CI-AKI 5 and noted that patients with estimated glomerular filtration rate (eGFR) of 60 mL/min have a very low risk of CI-AKI. These authors commented that intraarterial contrast appears to carry twice the risk of CI-AKI as does intravenous contrast.…”

Section: Iodine Dye and The Kidneys Mechanism Of Contrast Damage To Tmentioning

confidence: 99%

Renal Iodine Dye Risk, Age, and the Acute Coronary Syndrome

Whayne

2015

Angiology

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“…26,27 These studies were performed primarily by physicians and researchers; the study by Solomon et al 13 was the only investigation in which one of the authors was a nurse. Contrast-induced nephropathy prevention has been a topic of interest in nursing research, and reviews have published 29,30 ; however, no treatment path has clearly reduced the risk for CI-AKI in all populations of patients. We report here the first development of a quality improvement task force to reduce CI-AKI led and implemented by nursing professionals.…”

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Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety

Lambert

Chaisson

Horton

et al. 2017

Critical Care Nurse

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BACKGROUND Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. OBJECTIVE To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. METHODS Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions. RESULTS Compared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material. CONCLUSIONS Standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.

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Contrast media induced nephropathy: A literature review of the available evidence and recommendations for practice

Cited by 23 publications

References 60 publications

Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

Risk factors and outcomes of contrast-induced nephropathy in hospitalised South Africans

Renal Iodine Dye Risk, Age, and the Acute Coronary Syndrome

Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety

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