When Prevention is Truly Better than Cure: Contrast-Associated Acute Kidney Injury in Percutaneous Coronary Intervention

Isaac, Tea; Gilani, Salima; Kleiman, Neal S.

doi:10.14797/mdcvj.1136

Cited by 3 publications

(1 citation statement)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anemia Systematic review and meta-analysis Wei et al (191) Hypotension Systematic review and meta-analysis Ong et al (192) Volume Depletion and Hemodynamic Instability Systematic review and meta-analysis Tea et al (193) NSAID, diuretics and other nephrotoxic drugs Systematic review and meta-analysis Zhang et al (194) ACE-I/ARB usage Randomized trial parallel-group, single-center CAPTAIN trial (195) Acute heart failure NYHA III-IV Multicenter retrospective study Tian et al (196) Hypoalbuminemia Systematic review and meta-analysis Liwei et al (197) Peri-procedural hyperglycemia Systematic review and meta-analysis Jakrin et al (198) Patient…”

Section: Patient-related Risk Factors-modifiable Weight Of Evidence E...mentioning

confidence: 99%

Contrast-induced acute kidney injury and its contemporary prevention

Sůva¹,

Kala²,

Poloczek³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

The complexity and application range of interventional and diagnostic procedures using contrast media (CM) have recently increased. This allows more patients to undergo procedures that involve CM administration. However, the intrinsic CM toxicity leads to the risk of contrast-induced acute kidney injury (CI-AKI). At present, effective therapy of CI-AKI is rather limited. Effective prevention of CI-AKI therefore becomes crucially important. This review presents an in-depth discussion of CI-AKI incidence, pathogenesis, risk prediction, current preventive strategies, and novel treatment possibilities. The review also discusses the difference between CI-AKI incidence following intraarterial and intravenous CM administration. Factors contributing to the development of CI-AKI are considered in conjunction with the mechanism of acute kidney damage. The need for ultimate risk estimation and the prediction of CI-AKI is stressed. Possibilities of CI-AKI prevention is evaluated within the spectrum of existing preventive measures aimed at reducing kidney injury. In particular, the review discusses intravenous hydration regimes and pre-treatment with statins and N-acetylcysteine. The review further focuses on emerging alternative imaging technologies, alternative intravascular diagnostic and interventional procedures, and new methods for intravenous hydration guidance; it discusses the applicability of those techniques in complex procedures and their feasibility in current practise. We put emphasis on contemporary interventional cardiology imaging methods, with a brief discussion of CI-AKI in non-vascular and non-cardiologic imaging and interventional studies.

show abstract

Section: Patient-related Risk Factors-modifiable Weight Of Evidence E...mentioning

confidence: 99%

Contrast-induced acute kidney injury and its contemporary prevention

Sůva¹,

Kala²,

Poloczek³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

Association between elevated CHA2DS2-VASC score and contrast-induced nephropathy among patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

Compensation based on work relative value unit for cardiovascular surgeons in Iran: A mixed method study

Forootan,

Danaei,

Hajebrahimi

et al. 2023

Journal of Education and Health Promotion

View full text Add to dashboard Cite

BACKGROUND: Work relative value unit (wRVU) is a tool for assessing surgeons' performance, compensation, and productivity. It appears that wRVU for cardiovascular procedures does not consider complexity and its value for lengthy operations is low. The aim of the study is to determine wRVU for cardiovascular procedures in Iran according to the proposed approach. MATTERIALS AND METHODS: This study was conducted as a mixed method in teaching hospitals in Tabriz in the period of September 2020 to December 2021. According to Hospital Information System and expert opinions, six procedures in cardiovascular surgery were included in the study. They were compared with 18 procedures in neurosurgery, orthopedics, and otorhinolaryngology in terms of the operation time and wRVU/min. Then, we calculated new wRVUs for the selected procedures based on surgeons' opinions, time measurements, and anesthetists' points of view by content analysis in qualitative and statistical analysis in quantitative parts. RESULTS: Among the six cardiac procedures, the wRVU for five was under-estimated. The wRVU/min value ranged from 0/28 to 1/15 in the studied procedures. Findings demonstrate no significant relationship between the length of operations and the wRVU announced by the Ministry of Health and Medical Education (P value >0/05). Compared to studied procedures in four specialties, thoracoabdominal aortic aneurysm repair has the longest surgery time at 417 minutes. According to anesthesiologists, cardiovascular; orthopedics; ear, nose, and tongue; and neurosurgery specialties obtained 4/2, 2/9, 2/8, and 4, respectively, in terms of surgery duration, complexity, risk, and physical effort. CONCLUSION: Despite policymakers' attempts to bring justice to payments, it seems that there has been little progress in paying cardiovascular surgeons. Improper payment to cardiovascular surgeons will affect the future of the workforce in this specialty. Today, the need to reconsider the wRVUs in heart specialty is felt more than before.

show abstract

When Prevention is Truly Better than Cure: Contrast-Associated Acute Kidney Injury in Percutaneous Coronary Intervention

Cited by 3 publications

References 68 publications

Contrast-induced acute kidney injury and its contemporary prevention

Contrast-induced acute kidney injury and its contemporary prevention

Association between elevated CHA2DS2-VASC score and contrast-induced nephropathy among patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis

Compensation based on work relative value unit for cardiovascular surgeons in Iran: A mixed method study

Contact Info

Product

Resources

About