The persistent computed tomography nephrogram: its significance in the diagnosis of contrast-associated nephrotoxicity

Love, Leon; Johnson, Matthew S.; Bresler, Michael; Nelson, Jacob L.; Olson, Mary; Flisak, Michael E.

doi:10.1259/0007-1285-67-802-951

Cited by 42 publications

(13 citation statements)

References 6 publications

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“…According to one study, renal retention of CM at 24 h had a higher predictive value for CIN compared to the creatinine level [58]. Cortical retention of CM and CIN are more frequent in patients with reduced baseline renal function and with increasing age.…”

Section: Pathophysiology Of Contrast-induced Nephropathymentioning

confidence: 99%

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Aurelio¹,

Durante²

2014

Cardiology

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Contrast-induced nephropathy (CIN) is a well-known adverse event of therapeutic and diagnostic procedures requiring the adminstration of contrast medium (CM). The lack of a universal CIN definition and glomerular filtration rate markers that vary have resulted in a variety of reported incidences. The development of CIN is associated with an increase in the length of hospital stay and the risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure and the volume of CM administered are all associated with a risk for developing CIN. The literature suggests the use of low-osmolarity CM and supports volume supplementation before administration. Moreover, other strategies to avoid CIN, including treatment with N-acetylcisteine and sodium bicarbonate have variable levels of evidence. This review examines the main components of the pathogenesis and risk factors of CIN and possible preventive measures and therapies.

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Section: Pathophysiology Of Contrast-induced Nephropathymentioning

confidence: 99%

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Aurelio¹,

Durante²

2014

Cardiology

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“…1) has been described as a feature of CIN (Berns 1989;Love et al 1994). However, its presence is not always associated with a reduction in renal function (Jakobsen et al 1992;Yamazaki et al 1997a).…”

Section: Radiographic Featuresmentioning

confidence: 99%

Contrast Medium-Induced Nephropathy

Thomsen¹,

Stacul²,

Webb³

2014

Medical Radiology

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“…Patients are often referred for therapeutic intervention after undergoing coronary angiography at another institution; such patients should be evaluated for AKI before the interventional procedure is performed. In these cases, a persistent nephrogram density 73 or a urinary sodium concentration lower than 15 mEq/L indicates that the patient may already be experiencing contrastinduced AKI. Point-of-care serum creatinine assays would also be useful in this situation (Figure 3).…”

Section: Interventional Cardiologymentioning

confidence: 99%

Contrast-Induced Acute Kidney Injury: Specialty-Specific Protocols for Interventional Radiology, Diagnostic Computed Tomography Radiology, and Interventional Cardiology

Goldfarb

McCullough

McDermott

et al. 2009

Mayo Clinic Proceedings

138

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Contrast-induced acute kidney injury (AKI) (also known as contrast-induced nephropathy) is an abrupt deterioration in renal function that can be associated with use of iodinated contrast medium. Although the increase in serum creatinine concentration is transient in most cases, contrast-induced AKI may lead to increased morbidity and mortality rates in selected at-risk populations. This review summarizes the findings of a multidisciplinary panel composed of computed tomography radiologists, interventional radiologists, cardiologists, and nephrologists convened to address the specialty-specific issues associated with minimizing the incidence of contrast-induced AKI. As part of this initiative, the panel developed specialty-specific protocols for preventing contrast-induced AKI, taking into account, for example, the variations in patient risk profile, inpatient or outpatient status, and staffing resources that characterize various clinical settings. The 3 protocols, each reflecting a consensus of expert opinion, address the prevention of contrast-induced AKI in interventional radiology, diagnostic computed tomography radiology, and interventional cardiology settings. The protocols are presented in the context of a review of recent guidelines and published reports of trials that discuss contrast-induced AKI and its prevention. © 2009 Mayo Foundation for Medical Education and ResearchA cute kidney injury (AKI) is a heterogeneous disorder with multiple etiologies, risk factors, and clinical presentations. Although patients with AKI are ultimately cared for by nephrologists, AKI occurs in various clinical settings and is associated with a specific etiology in each. The term contrast-induced AKI refers to the disorder as it occurs after exposure to iodinated contrast media, a disorder that has been more commonly known as contrastinduced nephropathy (CIN). The Acute Kidney Injury Network, recognizing the need for improving outcomes associated with the various forms of AKI, recently proposed using the following standardized diagnostic definition in all cases: an abrupt (within 48 hours) reduction in kidney function, evidenced by an increase in the serum creatinine concentration of at least 0.3 mg/dL (to convert to µmol/L, multiply by 88.4) or at least 50% from baseline or a reduction in urine output (documented oliguria of <0.5 mL/kg/h for >6 hours).1,2 The criterion of oliguria does not apply for many cases of contrast-induced AKI because patients are treated with intravenous fluids before and after the procedure with the goal of increasing periprocedural urine output. The most commonly used definition of CIN is an increase from the baseline serum creatinine concentration of at least 0.5 mg/dL or at least 25% within 48 to 72 hours after exposure to contrast media. [3][4][5] Because the medical community is moving to adopt the concept and terminology of the American College of Radiology (ACR) in reference to studies of contrast-induced renal dysfunction and its prevention, 6 this report will do the same. However, we rec...

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The persistent computed tomography nephrogram: its significance in the diagnosis of contrast-associated nephrotoxicity

Cited by 42 publications

References 6 publications

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Contrast Medium-Induced Nephropathy

Contrast-Induced Acute Kidney Injury: Specialty-Specific Protocols for Interventional Radiology, Diagnostic Computed Tomography Radiology, and Interventional Cardiology

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