Incidence of contrast-induced acute kidney injury in a large cohort of all-comers undergoing percutaneous coronary intervention: Comparison of five contrast media

Azzalini, Lorenzo; Vilca, Luz María; Lombardo, Francesca; Poletti, Enrico; Laricchia, Alessandra; Beneduce, Alessandro; Maccagni, Davide; Demir, Ozan M.; Slavich, Massimo; Giannini, Francesco; Carlino, Mauro; Margonato, Alberto; Cappelletti, Alberto; Colombo, Antonio

doi:10.1016/j.ijcard.2018.08.097

Cited by 40 publications

(29 citation statements)

References 22 publications

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“…Follo wing a metaanalysis by Barrett and Carlisle, published in 1993, the use of hyperosmolar CM (HOCM) has largely been abandoned 30) . In a large Italian cohort undergoing percutaneous coronary intervention, there were no diffe rences in the adjusted risk of CAAKI across 4 lowosmolar CM (LOCM), compared with iodixanol, suggesting that overall risk is low with all modern contrast agents 31,32) . In line, Zo'o and colleagues performed a trial comparing the LOCM iobitrol with iodixanol.…”

Section: Type Of Contrastmentioning

confidence: 99%

Contrast-Associated Acute Kidney Injury (CA-AKI) in Children: Special Considerations

Windpessl¹,

Kronbichler²

2019

Child Kidney Dis

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Contrast-associated acute kidney injury (CA-AKI) is a major concern when iodinated contrast material is administered, especially in patients at risk. Efforts have been undertaken to understand the detrimental effects of contrast media (CM). With the use of low-osmolar or iso-osmolar CM the incidence of CA-AKI has steadily decreased within the past decade; however, especially in the pediatric population information is scarce. Incidence rates have been reported to range between 0% to 18.75%, particularly depending on indication, selection of population (i.e. preexisting co-morbidities), and definition of AKI. Different biomarkers have been proposed, but confirmatory studies are either lacking or have contributed to their lack of diagnostic power. Proteomic approaches have been employed and may pave the way to such discovery. Prevention strategies have been tested and proposed, but the recently published AMACING and PRESERVE trials have shown that commonly used strategies (such as systematic hydration or administration of N-acetylcysteine) have no role in the prevention of CA-AKI. We propose that thoughtful assessment of one's fluid state is the most appropriate approach and depending on the hydration status diuretics or fluid administration should be provided to achieve an euvolemic state ahead of contrast exposure.

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Section: Type Of Contrastmentioning

confidence: 99%

Contrast-Associated Acute Kidney Injury (CA-AKI) in Children: Special Considerations

Windpessl¹,

Kronbichler²

2019

Child Kidney Dis

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“…Although the third generation ICAs possesses iso-osmolality and induce lower incidence of side effects, they still may lead to nephropathy and adverse cardiac events [ 10 , 13 ]. A clinical trial including 475 patients with myocardial infarction who undergo primary percutaneous coronary intervention compared the side effect of the second generation low-osmolar contrast medium iopromide and the third generation iso-osmolar contrast medium iodixanol on acute kidney injury and myocardial infarction [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Bismuth chelate as a contrast agent for X-ray computed tomography

Guo

Qin

et al. 2020

J Nanobiotechnol

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Backgrounds: Due to the unexpected side effects of the iodinated contrast agents, novel contrast agents for X-ray computed tomography (CT) imaging are urgently needed. Nanoparticles made by heavy metal elements are often employed, such as gold and bismuth. These nanoparticles have the advantages of long in vivo circulation time and tumor targeted ability. However, due to the long residence time in vivo, these nanoparticles may bring unexpected toxicity and, the preparation methods of these nanoparticles are complicated and time-consuming. Methods: In this investigation, a small molecular bismuth chelate using diethylenetriaminepentaacetic acid (DPTA) as the chelating agent was proposed to be an ideal CT contrast agent. Results: The preparation method is easy and cost-effective. Moreover, the bismuth agent show better CT imaging for kidney than iohexol in the aspect of improved CT values. Up to 500 µM, the bismuth agent show negligible toxicity to L02 cells and negligible hemolysis. And, the bismuth agent did not induce detectable morphology changes to the main organs of the mice after intravenously repeated administration at a high dose of 250 mg/kg. The pharmacokinetics of the bismuth agent follows the first-order elimination kinetics and, it has a short half-life time of 0.602 h. The rapid clearance from the body promised its excellent biocompatibility. Conclusions: This bismuth agent may serve as a potential candidate for developing novel contrast agent for CT imaging in clinical applications.

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“…[52][53][54] Several studies investigated the effects of IOCM and LOCM providing mixed results. [55][56][57] As such, there is no robust evidence so far to favor LOCM over IOCM, which are both suitable options in the United States and European guidelines. 1,2 Intracoronary imaging and physiology The load of ICM plays a key role in CI -AKI, prompting investigations of contrast -sparing strategies that do not sacrifice image quality and procedure success.…”

Section: Iso -Osmolarity and Low Osmolarity Contrast Mediamentioning

confidence: 99%

Prevention of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention

Legnazzi¹,

Agnello²,

Capodanno³

2020

Kardiol Pol

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Intravascular administration of contrast media is an irreplaceable step of percutaneous coronary intervention. Since the latter is a very common procedure, contrast-induced acute kidney injury (CI-AKI) has become one of the most frequent causes of acute nephropathy, and a relevant prognostic impact of CI-AKI has been observed. Some patient comorbidities and procedural characteristics have been identified as key risk factors of CI-AKI. In this review, we discuss current evidence and future research directions on CI-AKI prevention in patients undergoing percutaneous coronary intervention.

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Incidence of contrast-induced acute kidney injury in a large cohort of all-comers undergoing percutaneous coronary intervention: Comparison of five contrast media

Cited by 40 publications

References 22 publications

Contrast-Associated Acute Kidney Injury (CA-AKI) in Children: Special Considerations

Contrast-Associated Acute Kidney Injury (CA-AKI) in Children: Special Considerations

Bismuth chelate as a contrast agent for X-ray computed tomography

Prevention of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention

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