Contrast-induced nephropathy


Cite item

Full Text

Abstract

The increasing number of invasive procedures done with contrast agents makes the prevention of their induced nephropathy more urgent. At present, different methods are being developed to prevent contrast-induced nephropathy (CIN) with antioxidants, intrarenal vasodilators, hydration therapy, by accurately determining the amount of excreted fluid obtained from a urinary catheter and less toxic iodine-containing contrast agents are being put into practice. Unfortunately, the current guidelines for the prevention of CIN are inadequately followed in both Russia and foreign countries. This review covers the main components of the pathogenesis and risk factors of this pathology and its possible preventive measures.

Full Text

Индуцированная контрастными веществами нефропатия. - Аннотация. С увеличением количества инвазивных вмешательств, проводимых с применением контрастных веществ (КВ), профилактика вызванной ими нефропатии становится все более актуальной. В настоящее время разрабатываются различные методы профилактики индуцированной КВ нефропатии (ИКВН) с применением антиоксидантов, интраренальным введением вазодилататоров, проведением гидратационной терапии в соответствии с точным определением количества полученной по мочевому катетеру выделенной жидкости, а также внедрение в практику менее токсичных содержащих йод КВ. К сожалению, современные рекомендации по профилактике ИКВН соблюдаются клиницистами в недостаточной степени как в России, так и за рубежом. Данный обзор освещает основные звенья патогенеза, факторы риска развития и меры возможной профилактики этой патологии.
×

About the authors

O Iu Mironova

References

  1. Stacul F., vab der Molen A.J., Reimer P. et al., on behalf of the Contrast Media Safety Committee of European Society of Urogental Radiology (ESUR). Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2001; 21: 2527-2541.
  2. Reddan D., Laville M., Garovic V.D. Contrast-induced nephropathy and its prevention: what do we really know from evidence-based findings? J Nephrol 2009; 22: 333-351.
  3. Davidson C.J., Hlatky M., Morris K.G. et al. Cardiovascular and renal toxicity of a nonionic radiographic contrast agent after cardiac catheterization. A prospective trial. Ann Intern Med 1989; 110: 119-124.
  4. McCullough P. A., Sandberg K.R. Epidemiology of contrast-induced nephropathy. Rev Cardiovasc Med 2003; 4: 53-59.
  5. Bartholomew B.A., Harjai K.J., Dukkipati S. et al. Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol 2004; 93: 1515-1519.
  6. Hou S.H., Bushinsky D.A., Wish J.B. et al. Hospital-acquired renal insufficiency: a prospective study. Am J Med 1983;74:243-248.
  7. McCullough P.., Adam A., Becker C.R. et al., on behalf of the CIN Consensus Working Panel. Risk prediction of contrast-induced nephropathy. Am J Cardiol 2006; 98 (suppl): 27K-36K.
  8. Levy E.M., Viscoli C.M., Horwitz R.I. The effect of acute renal failure on mortality: a cohort analysis. JAMA 1996; 275: 1489-1494.
  9. Hauben M., Norwich J., Shapiro E. et al. Multiple cholesterol emboli syndrome - six cases identified through the spontaneous reporting system. Angiology 1995; 46: 779-784.
  10. Bonser R.S., Buckels J.A.C., Woodward D.A.K., Bullen B.R. Atheroembolic renal failure after transfemoral aortography: a case report. Vasc Surg 1985; 19: 439-442.
  11. Vassalotti J.A., Delgado F.A., Whelton A. Atheroembolic renal disease. Am J Ther 1996; 3: 544-549.
  12. Saklayen M.G., Gupta S., Suryaprasad A., Azmeh W. Incidence of atheroembolic renal failure after coronary angiography - a prospective study. Angiology 1997; 48: 609-613.
  13. Thadhani R.I., Camargo C.A. Jr, Xavier R.J. et al. Atheroembolic renal failure after invasive procedures: natural history based on 52 histologically proven cases. Medicine (Baltimore) 1995; 74: 350-358.
  14. Morcos S.K., Thomsen H.S., Webb J.A.W. et al. Contrast-media-induced nephrotoxicity: a consensus report. Eur Radiol 1999; 9: 1602-1613.
  15. Toprak O. Risk markers for contrast-induced nephropathy. Am J Med Sci 2007; 334: 283-290.
  16. Bartholomew B.A., Harjai K.J., Dukkipati S. et al. Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol 2004; 93: 1515-1519.
  17. Brown J.R., DeVries J.T., Piper W.D. et al. Serious renal dysfunction after percutaneous coronary interventions can be predicted. Am Heart J 2008; 155: 260-266.
  18. McCullough P.A., Wolyn R., Rocher L.L. et al. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997; 103: 368-375.
  19. Mehran R., Aymong E. D., Nikolsky E. et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004; 44: 1393-1399.
  20. Rihal C.S., Textor S.C., Grill D.E. et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105: 2259-2264.
  21. Expressing the Modification of Diet in Renal Disease Study Equation for Estimating Glomerular Filtration Rate with Standardized Serum Creatinine Values. Clin Chem 2007; 53 (4): 766-772.
  22. Dangas G., Iakovou I., Nikolsky E. et al. Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. Am J Cardiol 2005; 95: 13-19.
  23. Glassock R.J., Winearls C. The global burden of chronic kidney disease: how valid are the estimates? Nephron Clin Pract 2008; 10: c39-c47.
  24. Delanaye P., Cohen E.P. Formula-based estimates of the GFR: equations variable and uncertain. Nephron Clin Pract 2008; 110: c48-c54.
  25. Parfrey P.S., Griffiths S.M., Barrett B.J. et al. Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both. A prospective controlled study. New Engl J Med 1989; 320: 143-149.
  26. Gruberg L., Mintz G.S., Mehran R. et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol 2000; 36: 1542-1548.
  27. Marenzi G., Lauri G., Assanelli E. et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 2004; 44: 1780-1785.
  28. Morcos S.K. Prevention of contrast media induced nephrotoxicity after angiographic procedures. J Vasc Interv Radiol 2005; 16: 13-23.
  29. McCullough P.A., Soman S.S. Contrast-induced nephropathy. Crit Care Clin 2005; 21: 261-280.
  30. Nikolsky E., Mehran R., Lasic Z. et al. Low hematocrit predicts contrast-induced nephropathy after percutaneous coronary interventions. Kidney Int 2005; 67: 706-713.
  31. McCarthy C.S., Becker J.A. Multiple myeloma and contrast media. Radiology 1992; 183: 519-521.
  32. Preda L., Agazzi A., Raimondi S. et al. Effect on renal function of an iso-osmolar contrast agent in patients with monoclonal gammopathies. Eur Radiol 2011; 21: 63-69.
  33. Katzberg R.W., Lamba R. Contrast-induced nephropathy after intravenous administration: fact or fiction? Radiol Clin North Am 2009; 47: 789-800.
  34. Davidson C., Stacul F., McCullough P.A. et al. Contrast medium use. Am J Cardiol 2006; 98: 42K-58K.
  35. Barrett B.J., Carlisle E.J. Meta-analysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media. Radiology 1993; 188: 171-178.
  36. Aspelin P., Aubry P., Fransson S.G. et al. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 2003; 348: 491-499.
  37. Chalmers N., Jackson R.W. Comparison of iodixanol and iohexol in renal impairment. Br J Radiol 1999; 72: 701-703.
  38. McCullough P.A., Bertrand M.E., Brinker J.A. et al. A meta-analysis of the renal safety of isosmolar iodixanol compared with low-osmolar contrast media. J Am Coll Cardiol 2006; 48: 692-699.
  39. Solomon R. The role of osmolality in the incidence of contrast-induced nephropathy: a systematic review of angiographic contrast media in high risk patients. Kidney Int 2005; 68: 2256-2263.
  40. Anderson J.L., Adams C.D., Antman E.M. et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction - executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction). J Am Coll Cardiol 2007; 50: 652-726.
  41. McCullough P.A. Contrast-induced acute kidney injury. J Am Coll Cardiol 2008; 51: 1419-1428.
  42. Lindsay J., Apple S., Pinnow E.E. et al. Percutaneous coronary intervention-associated nephropathy foreshadows increased risk of late adverse events in patients with normal baseline serum creatinine. Catheter Cardiovasc Interv 2003; 59: 338-343.
  43. Freeman R.V., O'Donnell M., Share D. et al. Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose. Am J Cardiol 2002; 90: 1068-1073.
  44. Manske C.L., Sprafka J.M., Strony J.T. et al. Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography. Am J Med 1990; 89: 615-620.
  45. Laskey W.K., Jenkins C., Selzer F. et al. NHLBI Dynamic Registry Investigators. Volume-to-creatinine clearance ratio: a pharmacokinetically based risk factor for prediction of early creatinine increase after percutaneous coronary intervention. J Am Coll Cardiol 2007; 50: 584-590.
  46. Волгина Г.В. Контрастиндуцированная нефропатия. Радиология - практика 2007; 6: 42-53.
  47. Tumlin J., Stacul F., Adam A. et al. Pathophysiology of Contrast-Induced Nephropathy. Am J Cardiol 2006; 98: 14K-20K.
  48. McCullough P.A., Adam A., Becker C.R. et al. Risk prediction of contrast-induced nephropathy. Am J Cardiol 2006; 98: 27K-36K.
  49. Stacul F., Adam A., Becker C.R. et al. Strategies to reduce the risk of contrast-induced nephropathy. Am J Cardiol 2006; 98: 59K-77K.
  50. Trivedi H.S., Moore H., Nasr S. et al. A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity. Nephron Clin Pract 2003; 93: C29-C34.
  51. Mueller C., Buerkle G., Buettner H.J. et al. Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydratation regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med 2002; 162: 329-336.
  52. Merten G.J., Burgess W.P., Gray L.V. et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 2004; 291: 2328-2334.
  53. Brar S. A randomized controlled trial for the prevention of contrast induced nephropathy with sodium bicarbonate vs. sodium chloride in persons undergoing coronary angiography (the MEENA Trial). Paper presented at: 56th Annual Scientific Session of the American College of Cardiology; March 24-27, 2007; New Orleans, Louisiana.
  54. Meier P., Ko D.T., Tamura A. et al. Sodium bicarbonate-based hydration prevents contrast-induced nephropathy: a meta-analysis. BMC Med 2009; 7: 23.
  55. Tamura A., Goto Y., Miyamoto K. et al. Efficacy of single-bolus administration of sodium bicarbonate to prevent contrast-induced nephropathy in patients with mild renal insufficiency undergoing an elective coronary procedure. Am J Cardiol 2009; 104: 921-925.
  56. Brigouri C., Colombo A., Airoldi F. et al. N-acetylcysteine versus fenoldopam mesylate to prevent contrast agent-associated nephrotoxicity. J Am Coll Cardiol 2004; 44: 762-765.
  57. Majumdar S.R., Kjellstrand C.M., Tymchak W.J. et al. Forced euvolemic diuresis with mannitol and furosemide for prevention of contrast-induced nephropathy in patients with CKD undergoing coronary angiography: a randomized controlled trial. Am J Kidney Dis 2009; 54: 602-609.
  58. Ng T.M., Shurmur S.W., Silver M. et al. Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN) Int J Cardiol 2006; 109: 322-328.
  59. Stone G.W., McCullough P.A., Tumlin J.A. et al. Fenoldopam mesylate for the prevention of contrast-induced nephropathy: a randomized controlled trial. JAMA 2003; 290: 2284-2291.
  60. Attallah N., Yassine L., Musial J. et al. The potential role of statins in nephropathy. Clin Nephrol 2004; 62: 273-278.
  61. Boscheri A., Weinbrenner C. Botzek B. et al. Failure of ascorbic acid to prevent contrast-induced nephropathy in patients with renal dysfunction. Clin Nephrol 2007; 68: 279-286.
  62. Briguori C., Airoldi F., D'Andrea D. et al. Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL): a randomized comparison of 3 preventive strategies. Circulation 2007; 115: 1211-1217.
  63. Ix J.H., Mc Cullough C.E., Chertow G.M. Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis. Nephrol Dial Transplant 2004; 19: 2747-2753.
  64. Huber W., Eckel F., Hennig M. et al. Prophylaxis of contrast material-induced nephropathy in patients in intensive care: acetylcysteine, theophylline, or both? A randomized study. Radiology 2006; 239: 793-804.
  65. Jo S. H., Koo B.K., Park J.S. et al. Prevention of radiocontrast medium-induced nephropathy using short-term high-dose simvastatin n patients with renal insufficiency undergoing coronary angiography (PROMISS) trial - a randomized controlled study. Am Heart J 2008; 155: 499.e11-499.e8.
  66. Kelly A.M., Dwamena B., Cronin P. et al. Meta-analysis: effectiveness of drugs for preventing contrast-induced nephropathy. Ann Intern Med 2008; 148: 284-294.
  67. Khanal S., Attallah N., Smith D.E. et al. Statin therapy reduces contrast-induced nephropathy: an analysis of cotemporary percutaneous interventions. Am J Med 2005; 118: 843-849.
  68. Patti G., Nusca A., Chello M. et al. Usefulness of statin pretreatment to prevent contrast-induced nephropathy and to improve long-term outcome in patients undergoing percutaneous coronary interventions. Am J Cardiol 2008; 101: 279-285.
  69. Spargias K., Adrendes E., Demerouti E. et al. Iloprost prevents contrast-induced nephropathy in patients with renal dysfunction undergoing coronary angiography intervention. Circulation 2009; 120: 1793-1799.
  70. Spargias K., Alexopoulos E., Kyrzopoulos S. et al. Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. Circulation 2004; 110: 2837-2842.
  71. Frank H., Werner D., Lorusso V. et al. Simultaneous hemodyalisis during coronary angiography fails to prevent radiocontrast-induced nephropathy in chronic renal failure. Clin Nephrol 2003; 60: 176-182.
  72. Fishman E.K., Reddan D. What are radiologists doing to prevent contrast-induced nephropathy (CIN) compared with measures supported by current evidence? A survey of European radiologists on CIN associated with computed tomography. Acta Radiol 2008; 49: 310-320.
  73. Дундуа Д.П., Кавтеладзе З.А., Бабунашвили А.М. и др. Контрастиндудированная нефропатия: обзор литературы и предварительные данные клинического исследования. Междунар журн интервенцион кардиоангиол 2007; 4: 52-58.
  74. Дундуа Д.П., Кавтеладзе З.А., Бабунашвили А.М. и др. Контрастиндуцированная нефропатия: методы профилактики и лечения. Междунар журн интервенцион кардиоангиол 2008; 14: 34-35.
  75. Rudnick M. R., Goldfarb S., Wexler L. et al. Nephrotoxicity of ionic and non-ionic contrast media in 1196 patients: a randomized trial. Kidney Int 1995; 47: 254-261.
  76. Reddan D., Fshman E.K. Radiologists' knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: a survey of European radiologists. Eur J Radiol 2008; 66: 235-245.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2013 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies