TY - JOUR
T1 - Prevention of contrast induced nephropathy
T2 - Recommendations for the high risk patient undergoing cardiovascular procedures
AU - Schweiger, Marc J.
AU - Chambers, Charles E.
AU - Davidson, Charles J.
AU - Zhang, Shaoheng
AU - Blankenship, James
AU - Bhalla, Narinder P.
AU - Block, Peter C.
AU - Dervan, John P.
AU - Gasperetti, Christine
AU - Gerber, Lowell
AU - Kleiman, Neal
AU - Krone, Ronald J.
AU - Phillips, William J.
AU - Siegel, Robert M.
AU - Uretsky, Barry F.
AU - Laskey, Warren K.
PY - 2007/1
Y1 - 2007/1
N2 - Contrast induced nephropathy (CIN) is the third leading cause of hospital aquired renal failure and is associated with significant morbidity and mortality. Chronic kidney disease is the primary predisposing factor for CIN. As estimated glomerular filtration rate <60 ml/1.73 mm2 represents significant renal dysfunction and defines patients at high risk. Modifiable risk factors for CIN include hydration status, the type and amount of contrast, use of concomitant nephrotoxic agents and recent contrast administration. The cornerstone of CIN prevention, in both the high and low risk patients, is adequate parenteral volume repletion. In the patient at increased risk for CIN it is often appropriate to withhold potentially nephrotoxic medications, and consider the use of n-acetylcysteine. In patients at increased risk for CIN the use of low or iso-osomolar contrast agents should be utilized and strategies employed to minimize contrast volume. In these patients serum creatinine should be obtained forty-eight hours post procedure and it is often appropriate to continue withholding medications such as metformin or non steroidal anti-inflammatories until renal function returns to normal.
AB - Contrast induced nephropathy (CIN) is the third leading cause of hospital aquired renal failure and is associated with significant morbidity and mortality. Chronic kidney disease is the primary predisposing factor for CIN. As estimated glomerular filtration rate <60 ml/1.73 mm2 represents significant renal dysfunction and defines patients at high risk. Modifiable risk factors for CIN include hydration status, the type and amount of contrast, use of concomitant nephrotoxic agents and recent contrast administration. The cornerstone of CIN prevention, in both the high and low risk patients, is adequate parenteral volume repletion. In the patient at increased risk for CIN it is often appropriate to withhold potentially nephrotoxic medications, and consider the use of n-acetylcysteine. In patients at increased risk for CIN the use of low or iso-osomolar contrast agents should be utilized and strategies employed to minimize contrast volume. In these patients serum creatinine should be obtained forty-eight hours post procedure and it is often appropriate to continue withholding medications such as metformin or non steroidal anti-inflammatories until renal function returns to normal.
KW - Contrast induced nephropathy
KW - Hydration
KW - Radiographic contrast media
KW - Renal failure
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U2 - 10.1002/ccd.20964
DO - 10.1002/ccd.20964
M3 - Review article
C2 - 17139671
AN - SCOPUS:33845975983
SN - 1522-1946
VL - 69
SP - 135
EP - 140
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 1
ER -