Nephrotoxicity of contrast media

Berns, Arnold S.

doi:10.1038/ki.1989.254

Cited by 272 publications

(145 citation statements)

References 88 publications

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…Clearly, there is a synergistic effect of diabetes and pre existing renal insufficiency. 32 As expected, the presence of a previous renal insufficiency, defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m 2 , turned out to be a very sensitive index of CIN. 6,33 Based on the available evidence in the literature the risk of CIN is inversely related to the calculated estimated GFR (eGFR).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for contrast induced nephropathy: A study among Italian patients

Evola

Lunetta

Macaione

et al. 2012

Indian Heart Journal

View full text Add to dashboard Cite

Atherosclerosis Percutaneous coronary intervention Coronary angiography a b s t r a c tThis study aimed to make a profile of patients at highest risk of developing contrast induced nephropathy (CIN) in order to take appropriate prevention measures. 591 patients undergoing coronary procedures were divided into two groups: patients with (CIN-group) and without (no-CIN) an increase in creatinine level equal or more than 25% from baseline values within 24e48 h after the coronary procedure. All patients underwent an accurate anamnesis, objective exam, hematochemical measurements, and diagnostic exams. The results of this study while confirming that, average age ( p ¼ 0.01), diabetes mellitus IntroductionContrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired acute renal failure, accounting for 10% of all cases of hospital-acquired renal failure. 1 It is commonly defined as an acute deterioration of the renal function characterized by a significant increase in serum creatinine levels, usually more than 0.5 mg/dl (44 mmol/L) or 25% of baseline levels, within 24e48 h after exposure to a contrast agent compared to baseline serum creatinine values, when alternative explanations for renal impairment have been excluded. 2 The CIN is associated with increased mortality and morbidity and costs, 3e5 in fact, although usually transient, its resolution needs 1e3 weeks on average, the impairment of renal function may be permanent in some cases with the risk of progression towards chronic renal failure and the necessity of a temporary or permanent dialysis. 6 Prevention is the key to reduce the incidence of CIN and it begins with identification of the high risk patient coupled with appropriate peri-procedural management. Many studies have been conducted to identify the main risk factors for CIN, in fact many score systems have been proposed 7e12 and increasing number of guidelines have been suggested in literature 13,14 to help lessen the complication of CIN. Available online at www.sciencedirect.com journal homepage: w ww.el sevier.com/locate /ihj i n d i a n h e a r t j o u r n a l 6 4 ( 2 0 1 2 ) 4 8 4 e4 9 1

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for contrast induced nephropathy: A study among Italian patients

Evola

Lunetta

Macaione

et al. 2012

Indian Heart Journal

View full text Add to dashboard Cite

show abstract

“…Presence of other risk factors, such as renal insufficiency or proteinuria, in diabetics further increases the risk for CIN. In study by Berns et al [1], CIN occurred in 27% of diabetics with baseline serum creatinine 2.0 to 4.0 mg/dL and in 81% of those with serum creatinine >4.0 mg/dL. In a study by Toprak et al [28], a total of 421 patients with CockcroftGauldt estimated creatinine clearance between 15 and 60 mL/min were divided into three groups: diabetes mellitus (n ¼ 137; glucose 126 mg/dL), pre-diabetes (n ¼ 140; glucose between 100 and 125 mg/dL), and normal fasting glucose (n ¼ 144; glucose < 100 mg/ dL).…”

Section: Diabetes Mellitusmentioning

confidence: 95%

“…The definition includes absolute or relative increase in creatinine level after exposure to contrast agent compared with baseline value, when alternative explanations for renal impairment have been excluded. It occurs within 24-48 hr of the exposure, with creatinine level typically peaking 3-5 days after procedure and returning to baseline or near baseline value in 1-3 weeks [1]. The cut-off increase in creatinine defining CIN differs in various studies (from 20 to 50% or in absolute values from 0.5 to 1.0 mg/dL), making it difficult to compare the results.…”

Section: Introductionmentioning

confidence: 99%

Contrast‐induced nephropathy

Pučelíková

Dangas

Mehran

2007

Cathet Cardio Intervent

View full text Add to dashboard Cite

Contrast induced nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. Contrast-induced hemodynamic and direct cytotoxic effects on renal structures are highly evident in its pathogenesis, whereas other mechanisms are still poorly understood. CIN is typically defined as an increase in serum creatinine by either 0.5 mg/dl or by 25% from baseline within the first 2-3 days after contrast administration. Although rare in the general population, CIN has a high incidence in patients with an underlying renal disorder, in diabetics, and the elderly. The risk factors are synergistic in their ability to produce CIN. The best way to prevent CIN is to identify the patients at risk and to provide adequate peri-procedural hydration. The role of various drugs in prevention of CIN is still controversial and warrants future studies. Despite remaining uncertainty regarding the degree of nephrotoxicity produced by various contrast agents, in current practice non-ionic low-osmolar contrast media are preferred over the high-osmolar contrast media in patients with renal impairment.

show abstract

“…There is a synergistic effect in patients having diabetes mellitus with pre-existing renal insufficiency. 14,15 The cause for development of CIN in patients undergoing percutaneous coronary intervention is variable. It can be due to the direct toxic effect of the contrast dye on kidney, Contrast agents will lead to an increase in osmolality, thus resulting in vasoconstriction of the afferent arterioles and subsequently medullary ischemia.…”

Section: Discussionmentioning

confidence: 99%

Risk of Contrast induced nephropathy in patients undergoing Primary coronary angioplasty

Kumar

Dev

chokkanna

2012

Int J of Biomed & Adv Res

View full text Add to dashboard Cite

Background: Contrast induced nephropathy (CIN) is one of the common cause for hospital acquired renal failure in patients undergoing coronary angioplasty for acute myocardial infarction. The aim of this study was to assess the renal function in patients after primary coronary angioplasty by estimating the levels of serum creatinine (Sr. Cr) Materials & Methods: Sample sizes of 51 subjects were included for the study. Serum creatinine levels were measured before and after the procedure. The difference in Serum creatinine levels was calculated.CIN was defined as increase in Sr Cr >0.5 or >25% compared to the baseline value. Results: Out of the 51 cases, CIN occurred in 7.8% (4 cases). In addition,19.6 %( 10 cases) had preexisting renal insufficiency out of which 3 subjects developed CIN.According to recently proposed definition of contrast nephropathy 5.9 %(3 cases) and 7.8% (4 cases) were in grade 1and 2 respectively. Incidence of CIN in patients with diabetes mellitus was found to be statistically significant (p<0.05) as compared to patients without diabetes mellitus. Conclusion: CIN is a common complication of primary coronary angioplasty. Its incidence is more in patients with pre existing renal insufficiency and diabetes mellitus compared to patients with normal renal function and without any underlying risk factors.

show abstract

Nephrotoxicity of contrast media

Cited by 272 publications

References 88 publications

Risk factors for contrast induced nephropathy: A study among Italian patients

Risk factors for contrast induced nephropathy: A study among Italian patients

Contrast‐induced nephropathy

Risk of Contrast induced nephropathy in patients undergoing Primary coronary angioplasty

Contact Info

Product

Resources

About