Radiological iodinated contrast-induced nephropathy

Llorente, Enrique; Balsa, Eva de Miguel

doi:10.1016/j.rceng.2018.09.002

Cited by 5 publications

(7 citation statements)

References 61 publications

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“…This is most likely due to the use of contrast agents during the procedure. 46 Therefore, for ensuring the therapeutic effect of AMLs and benefiting renal function, transarterial embolization could be considered as an alternative management to surgery, especially for older people and patients with a poor renal function or physical condition.…”

Section: Discussionmentioning

confidence: 99%

Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis

Lin

Guan

et al. 2019

J Int Med Res

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Objective The present study aimed to evaluate renal function, complications, and changes in tumor size after transarterial embolization for patients with renal angiomyolipomas. Methods We performed a meta-analysis of transarterial embolization in patients with renal angiomyolipomas from January 1994 to April 2018. Endpoints of interest were the estimated glomerular filtration rate, serum creatinine levels, blood urea nitrogen levels, complications, and reduction of tumors. Results A total of 30 studies comprising 653 patients were included. A total of 32.0% of patients were treated by urgent transarterial embolization for spontaneous ruptured renal angiomyolipomas. Other patients sought to relieve symptoms or received embolism prophylactically. The estimated glomerular filtration rate showed no significant difference between before and after embolization. In 363 patients with data on complications, post-embolization syndrome occurred most frequently (54.0%). Only 16 (4.4%) patients had major complications. The diameter of sporadic angiomyolipomas was reduced by a mean of 2.09 cm (95% confidence interval [CI], 0.73–3.45 cm; I2 = 29.3%) and they were reduced in size by 30.0% (95% CI, 16.0%–44.0%; I2 = 27.9%). Conclusions Transarterial embolization of renal angiomyolipomas affects renal function preservation, with a low complication rate. Transarterial embolization is useful for sporadic and tuberous sclerosis complex-related angiomyolipomas.

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Section: Discussionmentioning

confidence: 99%

Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis

Lin

Guan

et al. 2019

J Int Med Res

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“…The incidence of CIN is <3% in patients with normal renal function but up to 50% in patients with CKD. Following the use of isotonic and hypotonic contrast media, the incidence of CIN may be overestimated, but in patients adopting transarterial administration and with eGFR <30 mL/min/1.73 m 2 , the incidence of CIN still increased significantly ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Reduction in risk of contrast-induced nephropathy in patients with chronic kidney disease and diabetes mellitus by enhanced external counterpulsation

Zhao¹,

Zhong²,

Wu³

et al. 2022

Front. Endocrinol.

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ObjectiveTo evaluate the efficacy of enhanced external counterpulsation (EECP) in the prevention of contrast-induced nephropathy (CIN) in patients with combined chronic kidney disease (CKD) and diabetes mellitus (DM) by comparing the changes in renal function-related indicators in patients before and after coronary angiography (CAG) or percutaneous coronary intervention (PCI).MethodsThere were 230 subjects consecutively included in the study. Of these, 30 cases with DM underwent rehydration therapy, and 200 cases underwent EECP therapy in addition to rehydration therapy, comprising 53 patients with DM and 147 patients without. All the patients were tested to measure the renal function indicators before and after CAG/PCI.ResultsThe postoperative results of blood urea nitrogen (BUN), serum creatinine (Scr), estimated glomerular filtration rate (eGFR), B2 microglobulin, and high-sensitivity C-reactive protein in the three groups showed a statistically significant difference (P < 0.05). After EECP therapy, patients with DM showed a significant decrease in BUN (9.1 ± 4.2 vs. 7.2 ± 3.0, t = 3.899, P < 0.001) and a significant increase in eGFR (41.5 ± 12.7 vs. 44.0 ± 15.6, t = −2.031, P = 0.047), while the patients without DM showed a more significant difference (P < 0.001). Patients with DM showed a lower percentage of elevated Scr (66.7% vs. 43.4%, P = 0.042), a higher percentage of elevated eGFR (30.0% vs. 52.8%, P = 0.044), and a lower incidence of CIN (16.7% vs. 3.8%, P = 0.042) after EECP therapy.ConclusionTreatment with EECP can reduce Scr in patients with combined CKD and DM post CAG/PCI, increase eGFR, and decrease the incidence of CIN.

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“…Este riesgo de complicaciones, con efecto en la morbimortalidad de los pacientes, ha llevado a desarrollar protocolos de seguimiento tomográfico estrictos 1,29,30 . Esta recomendación que tiene como objetivo identificar en fase temprana complicaciones vinculadas con la intervención endovascular acarrea varios problemas: el riesgo de nefrotoxicidad relacionado con el contraste, el riesgo oncológico tras la exposición a dosis altas de radiación y el alto costo sanitario 14,15 . En este estudio, 94.3% de los pacientes se sometió al menos a una angiotomografía durante el primer año de seguimiento.…”

Section: Discussionunclassified

“…Otras técnicas de imagen, como la ecografía Doppler, poseen menor grado de evidencia para extender su recomendación, sobre todo durante el primer año de la intervención 13 . No obstante, dicho seguimiento tomográfico estricto tiene como desventajas el riesgo oncológico de la exposición a altas dosis acumulativas de radiación 14 y la nefrotoxicidad secundaria al material de contraste 15 . Este último factor es muy importante, dado que muchos pacientes sometidos a reparación endovascular son comórbidos y la insuficiencia renal crónica es frecuente en este grupo poblacional, afectando hasta el 15% de los pacientes en el registro ENGAGE 16 .…”

Section: Introductionunclassified

Resultados a cinco años de la reparación electiva del aneurisma de aorta abdominal infrarrenal en un hospital universitario de Argentina

Bluro

Garagoli

Fiorini

et al. 2022

ACM

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¶ Ambos autores contribuyeron igualmente en el desarrollo del trabajo. ARTÍCULO DE INVESTIGACIÓN ResumenObjetivo: La evidencia surgida en Latinoamérica acerca de los resultados de la reparación electiva del aneurisma de aorta abdominal (AAA) es escasa, por lo que el objetivo de este estudio es abordar este aspecto en la población nacional. Método: Cohorte retrospectiva en la cual se incluyó de forma consecutiva a pacientes con AAA infrarrenal sometidos a reparación quirúrgica o endovascular en forma electiva desde enero de 2011 hasta mayo de 2017 en un hospital universitario de la Ciudad Autónoma de Buenos Aires. Los puntos finales primarios fueron la mortalidad perioperatoria y la mortalidad por todas las causas durante el seguimiento. Entre los puntos finales secundarios se evaluó el requerimiento de reintervenciones. Resultados: Se incluyó a 195 pacientes. La operación abierta se llevó a cabo en 72 pacientes (36.9%), mientras que el procedimiento endovascular se practicó en 123 (63.1%). La mortalidad perioperatoria en el grupo quirúrgico fue de 2.8%, sin registro de muertes en el grupo endovascular (p = 0.06). La mediana de seguimiento fue de 38 meses. La incidencia de mortalidad tardía fue de 7%/año en pacientes con reparación endovascular y de 6.7%/año en los quirúrgicos (p = 0.8). El requerimiento de reintervenciones fue significativamente mayor en el grupo endovascular (9.0% vs. 0%, p = 0.01). Conclusiones: La mortalidad perioperatoria y la mortalidad tardía de los pacientes tratados de manera electiva por AAA en forma quirúrgica o endovascular fueron similares, en tanto que los pacientes sometidos a reparación endovascular requirieron mayor cantidad de reintervenciones. Los resultados observados en la población no difieren de los publicados en Estados Unidos o Europa.

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Radiological iodinated contrast-induced nephropathy

Cited by 5 publications

References 61 publications

Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis

Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis

Reduction in risk of contrast-induced nephropathy in patients with chronic kidney disease and diabetes mellitus by enhanced external counterpulsation

Resultados a cinco años de la reparación electiva del aneurisma de aorta abdominal infrarrenal en un hospital universitario de Argentina

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