Radiologic Contrast-Induced Nephropathy

Berkseth, Robert O.; Kjellstrand, Carl M.

doi:10.1016/s0025-7125(16)31135-x

Cited by 146 publications

(30 citation statements)

References 85 publications

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“…However, factors other than hypoxic medullary injury may be involved in CIN pathogenesis. They include tubular obstruction by radiocontrast media, precipitated crystals of oxalate or uric acid [2] and direct tubular toxicity possibly involving the generation of oxygen free radicals and lipid peroxidation [2,3,4]. These processes may coexist and act in concert with hypoxic medullary injury [1].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography

et al. 2015

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Aims: Contrast-induced nephropathy (CIN) is one of the most common causes of hospital-acquired acute renal failure. Oxidative stress and vasoconstriction might play key roles in its pathogenesis. In a few experimental models, antioxidant properties of carvedilol have been documented. The aim of this study was to analyze and compare the effects of carvedilol and metoprolol on the development of CIN in patients undergoing coronary angiography. Methods: One hundred patients currently taking metoprolol and 100 patients currently taking carvedilol were enrolled into the study. Venous blood samples were obtained before and 48 h after contrast administration. Cystatin C and malondialdehyde values were examined and compared. CIN was defined as a creatinine increase of at least 25% or 0.5 mg/dl from the baseline value. Results: Seven patients in the carvedilol group (7%) and 22 patients in the metoprolol group (22%) developed CIN (p = 0.003). In the metoprolol group, the median cystatin C concentration increased significantly from 978 to 1,086 ng/ml (p = 0.001) 48 h after radiocontrast administration. In the carvedilol group, the median cystatin C concentration did not change significantly (1,143 vs. 1,068 ng/ml; p = 0.94). In the metoprolol group, the mean malondialdehyde concentration increased significantly from 7.09 ± 1.48 to 8.38 ± 2.6 nmol/l (p < 0.001). In the carvedilol group, the mean serum malondialdehyde concentration did not change significantly (7.44 ± 1.21 vs. 7.56 ± 1.11 nmol/l; p = 0.59). Conclusion: When compared to metoprolol, carvedilol might decrease oxidative stress and subsequent development of CIN.

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Section: Introductionmentioning

confidence: 99%

Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography

et al. 2015

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“…11 • 12 Berkseth and Kjellstrand 13 have proposed a protocol for the use of fluids, mannitol, and/or diuretics (see box above). This protocol is specifically recommended for patients with a baseline serum creatinine level greater than 2 mgldL; however, it can be used for any patient judged to be at significant risk as long as the use of mannitol and/or diuretics is not contraindicated.…”

Section: Adapted From Berkseth and Kjellstrand'mentioning

confidence: 99%

Radiocontrast-induced nephropathy

Mehra

Sharif²,

Bode³

1992

Postgraduate Medicine

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The principal predisposing factor in radiocontrast-induced nephropathy appears to be underlying renal insufficiency. Identifying patients at risk is of paramount importance when a diagnostic study is being chosen. Contrast-reliant studies should be avoided, if possible, in high-risk patients. If challenge with a contrast medium is essential, appropriate risk stratification and adequate patient preparation should be done beforehand. Ultimately, prevention is a better approach than cure.

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“…They are usually sodium or meglumine salts of diatrizoate and iothalamate. 16 They exist as anions at phys¬ iologic pH and there is minimal protein binding. Their acidic nature leads to low lipid solubility and they exhibit poor plasma membrane penetrance.…”

Section: Radiocontrast Agentsmentioning

confidence: 99%

Nephrotoxicity of Common Drugs Used in Clinical Practice

Cooper¹

1987

Arch Intern Med

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Radiologic Contrast-Induced Nephropathy

Cited by 146 publications

References 85 publications

Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography

Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography

Radiocontrast-induced nephropathy

Nephrotoxicity of Common Drugs Used in Clinical Practice

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