Title: Contrast-induced nephropathy in patients under going coronary interventions
- Michał Nowicki, Anna Masajtis, Katarzyna Murlikiewicz
- Review articles
- Polish Journal of Cardiology
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- Final page:
- contrast-induced nephropathy, contrast medium, chronic kidney disease
The use of radiological diagnostic and interventional procedures with intraarterial or intravenous administration of iodine-based contrast media increases in various areas of medicine including cardiology. This has resulted in a rapidly growing incidence of contrast-induced nephropathy (CIN). Administration ofthe iodine-based contrast medium can induce either an acute worsening of kidney function, i.e. acute renal failure or accelerate the progression of preexisting chronic kidney disease. Although the risk of kidney damage after exposure to a contrast agent is low in the general population it could be much higher in patients who under go coronary intervention due to a frequent occurrence of other risk factors of renal failure in this population such as advanced age, chronic heart failure, diabetes and atherosclerosis. Currently, hydration is a single widely accepted method of prevention of the contrast-induced nephropathy. The effectiveness of several other prophylactic measures has not been fully proven and the results of clinical trials have been contradictory. The most promising results were obtained with the preventive use of N-acetylcysteine and isotonic solution of sodium bicarbonate. It is certain that low-osmolar and iso-osmolar contrast media should be preferred to high-osmolarones.