Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media?

Koch, Jens‐Albrecht; Plum, J; Grabensee, B; Mödder, Ulrich

doi:10.1093/ndt/15.1.43

Cited by 113 publications

(57 citation statements)

References 23 publications

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“…Other agents that have shown some positive protective benefit against CIN in laboratory or clinical studies include theophylline or aminophylline [90][91][92][93] and prostaglandin E1 [94][95][96]. Equivocal results have been reported for NAC (see above discussion), ascorbic acid [97,98], fenoldapam [99,100], dopamine [101][102][103][104] , calcium channel blockers [105][106][107], atrial natriuretic peptide [103,108], L-arginine [109], and statins [110][111][112].…”

Section: Other Pharmacologic Protective Strategiesmentioning

confidence: 99%

Contrast-induced nephropathy: pathogenesis and prevention

Cronin

2010

Pediatr Nephrol

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Contrast-induced nephropathy (CIN) is the third most common cause of acute kidney injury in hospitalized patients. Diagnostic and interventional cardiovascular procedures generate nearly half the cases. Elderly patients and those with chronic kidney disease, diabetes, and cardiovascular disease are at greatest risk. Procedure-related risk factors include large volumes of contrast and agents with a high osmolality. Renal medullary ischemia arising from an imbalance of local vasoconstrictive and vasodilatory influences coupled with increased demand for oxygen-driven sodium transport may be the key to its pathogenesis. Contrast agents may also have a direct cytotoxic effect that operates through the generation of reactive oxygen species. Pre- and post-procedure administration of normal saline, isotonic sodium bicarbonate, N-acetylcysteine, and a variety of other pharmacologic agents have been used to prevent or mitigate CIN. While normal saline is generally accepted as protective against CIN, uncertainty still surrounds the role of sodium bicarbonate and N-acetylcysteine. Dialytic therapies before, during, and after exposure to contrast have been tested with mixed results. Logistical and economic disincentives argue against these modalities.

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Section: Other Pharmacologic Protective Strategiesmentioning

confidence: 99%

Contrast-induced nephropathy: pathogenesis and prevention

Cronin

2010

Pediatr Nephrol

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“…Doses of 10, 20 and 40 ng/kg/min of IV PGE1 administered one hour before the procedure for six hours. The 20 ng/kg/min dose presented better and statistically significant results compared to all the other groups to prevent CMIN 128 . However, further studies are required to confirm these results.…”

Section: Prostaglandinsmentioning

confidence: 80%

Nefropatia induzida pelos meios de contraste radiológico após cateterismo cardíaco diagnóstico e terapêutico

Ultramari¹,

Bueno²,

Cunha³

et al. 2006

Arq. Bras. Cardiol.

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“…The worsening of renal function after RxP is often transient, but CM/post-RxP nephropathy (the respective roles of CM and atheroembolism may be difficult to distinguish) might deteriorate to end-stage renal failure and/ or lead to a higher morbidity [1][2][3][4][5]. Up to now, only efforts to maintain adequate effective volemia with saline infusion [6,7], withdrawal of risk medication [6,7] and probably, as recently suggested, the prophylactic administration of acetylcysteine [8,9], prostaglandin E1 [10] or fenoldopam [11] have demonstrated a favorable effect on the incidence of CM/post-RxP nephropathy. The amount of CM infused is an independent risk factor for developing renal toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…In spite of various therapeutic approaches, a favorable effect was demonstrated only by giving special care to the maintenance of adequate effective volemia with saline infusion [6,7], withdrawal of risk medication [6,7] or, as recently suggested, the administration of prophylactic acetylcysteine [8,9], prostaglandin E1 [10] and probably fenoldopam [11]. Concerning the extracorporeal enhancement of CM clearance, hemodialysis sessions performed after radiological investigations/interventions did not convincingly improve the prognosis [12,13].…”

Section: Introductionmentioning

confidence: 97%

Does Continuous Venovenous Hemodiafiltration Concomitant with Radiological Procedures Provide a Significant and Safe Removal of the Iodinated Contrast Ioversol?

et al. 2003

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Background: The purpose of our study was to investigate whether continuous venovenous hemodiafiltration (CVVHDF) concomitant with radiological procedures (RxP) was feasible, well tolerated and could significantly remove iodinated contrast media (CM). Methods: 26 patients with various degrees of renal insufficiency who were submitted to RxP were included in the study. The CVVHDF session was started immediately before CM administration. All the patients were evaluated for feasibility and tolerability; furthermore a pharmacokinetic study was done on 12 patients to calculate the amount of CM eliminated. The baseline incidence of CM nephropathy was studied in 25 consecutive historical controls. Results: The CM administered was 208 ± 146 g; the fractional removal of CM was 9.2 ± 4.9% during RxP and 30.9 ± 20.7% during the whole CVVHDF session. Hemodynamic tolerance was excellent. The incidence of CM nephropathy in the experimental and control groups was 37 and 24%, respectively. Conclusions: CVVHDF during RxP is feasible and well tolerated but ioversol removal is modest. This fact together with the high incidence of renal function impairment, the complexity of the procedure and its intrinsic risks, and the large amount of resources needed discourage the routine use of CVVHDF as a prophylactic tool to avoid CM nephropathy.

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Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media?

Abstract: Results from this pilot-study suggest that intravenous PGE(1) may be used efficaciously and safely to prevent RCM-induced renal dysfunction in patients with pre-existing impaired renal function.

Cited by 113 publications

References 23 publications

Contrast-induced nephropathy: pathogenesis and prevention

Contrast-induced nephropathy: pathogenesis and prevention

Nefropatia induzida pelos meios de contraste radiológico após cateterismo cardíaco diagnóstico e terapêutico

Does Continuous Venovenous Hemodiafiltration Concomitant with Radiological Procedures Provide a Significant and Safe Removal of the Iodinated Contrast Ioversol?

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