Michael Rudnick1, Harold Feldman. 1. Renal Electrolyte and Hypertension Division, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania 19104, USA. rudnickm@uphs.upenn.edu
Abstract
BACKGROUND AND OBJECTIVES: Observational studies have demonstrated that short- and long-term mortality is increased in patients who develop contrast-induced nephropathy (CIN). The more clinically relevant questions, and the objectives of this review, are whether CIN is causally related to mortality, and to what extent could mortality in patients undergoing contrast procedures be reduced by preventing CIN. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A literature review was conducted, focusing on observational studies that assessed factors associated with mortality in patients with CIN. RESULTS: The deaths of some patients with CIN are complicated by factors that cannot be directly related to CIN, such as liver disease, sepsis, respiratory failure, bleeding, etc. However, it is plausible that CIN contributes to cardiovascular causes of death in patients with CIN. CONCLUSIONS: At the very least, CIN is a marker for increased mortality. More carefully designed prospective studies are needed to fully elucidate the relationship between CIN and death. In the absence of data disproving a causal relationship between CIN and death in all subgroups, reducing its incidence should remain a goal in clinical practice as well as a target for future research.
BACKGROUND AND OBJECTIVES: Observational studies have demonstrated that short- and long-term mortality is increased in patients who develop contrast-induced nephropathy (CIN). The more clinically relevant questions, and the objectives of this review, are whether CIN is causally related to mortality, and to what extent could mortality in patients undergoing contrast procedures be reduced by preventing CIN. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A literature review was conducted, focusing on observational studies that assessed factors associated with mortality in patients with CIN. RESULTS: The deaths of some patients with CIN are complicated by factors that cannot be directly related to CIN, such as liver disease, sepsis, respiratory failure, bleeding, etc. However, it is plausible that CIN contributes to cardiovascular causes of death in patients with CIN. CONCLUSIONS: At the very least, CIN is a marker for increased mortality. More carefully designed prospective studies are needed to fully elucidate the relationship between CIN and death. In the absence of data disproving a causal relationship between CIN and death in all subgroups, reducing its incidence should remain a goal in clinical practice as well as a target for future research.
Authors: Shu Min Tao; Julian L Wichmann; U Joseph Schoepf; Stephen R Fuller; Guang Ming Lu; Long Jiang Zhang Journal: Eur Radiol Date: 2015-12-18 Impact factor: 5.315
Authors: Edwin A Takahashi; David F Kallmes; Kristin C Mara; William S Harmsen; Sanjay Misra Journal: Diagn Interv Radiol Date: 2018-11 Impact factor: 2.630
Authors: Teemu Maaniitty; Iida Stenström; Valtteri Uusitalo; Heikki Ukkonen; Sami Kajander; Jeroen J Bax; Antti Saraste; Juhani Knuuti Journal: Int J Cardiovasc Imaging Date: 2016-07-12 Impact factor: 2.357
Authors: Andreas Linkermann; Jan-Ole Heller; Agnes Prókai; Joel M Weinberg; Federica De Zen; Nina Himmerkus; Attila J Szabó; Jan H Bräsen; Ulrich Kunzendorf; Stefan Krautwald Journal: J Am Soc Nephrol Date: 2013-07-05 Impact factor: 10.121
Authors: Mehmet Kanbay; Adrian Covic; Steven G Coca; Faruk Turgut; Ali Akcay; Chirag R Parikh Journal: Int Urol Nephrol Date: 2009-04-25 Impact factor: 2.370