Cristina Quintavalle1, Elvira Donnarumma, Danilo Fiore, Carlo Briguori, Gerolama Condorelli. 1. aDepartment of Molecular Medicine and Medical Biotechnologies, 'Federico II' University of Naples and IEOS, CNR, Naples bFondazione SDN, Napoli cLaboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy.
Abstract
PURPOSE OF REVIEW: Contrast-induced acute kidney injury (CI-AKI) accounts for approximately 10% of all causes of hospital-acquired renal failure, causes a prolonged in-hospital stay, and represents a powerful predictor of poor early and late outcome. Here, we highlight endpoints used to assess major strategies to prevent CI-AKI. RECENT FINDINGS: A general consensus exists on the beneficial prophylactic effect of hydration. This seems to act by increasing urine flow rate and, thereby, by limiting the time of contact between the contrast media and the epithelial tubular cells. On the contrary, both observational trials and randomized studies are often controversial in their conclusions on the efficacy of several drugs tested to prevent CI-AKI. Compounds evaluated include diuretics (furosemide), antioxidants (i.e., N-acetylcysteine and statins), and vasodilators (i.e., calcium antagonists, dopamine, and fenoldopam). Due to the negative and/or controversial clinical results, none of these drugs has been currently recommended to prevent CI-AKI. CONCLUSION: More reliable markers of acute kidney injury and new prophylactic strategies are warranted to prevent the incidence of CI-AKI.
PURPOSE OF REVIEW: Contrast-induced acute kidney injury (CI-AKI) accounts for approximately 10% of all causes of hospital-acquired renal failure, causes a prolonged in-hospital stay, and represents a powerful predictor of poor early and late outcome. Here, we highlight endpoints used to assess major strategies to prevent CI-AKI. RECENT FINDINGS: A general consensus exists on the beneficial prophylactic effect of hydration. This seems to act by increasing urine flow rate and, thereby, by limiting the time of contact between the contrast media and the epithelial tubular cells. On the contrary, both observational trials and randomized studies are often controversial in their conclusions on the efficacy of several drugs tested to prevent CI-AKI. Compounds evaluated include diuretics (furosemide), antioxidants (i.e., N-acetylcysteine and statins), and vasodilators (i.e., calcium antagonists, dopamine, and fenoldopam). Due to the negative and/or controversial clinical results, none of these drugs has been currently recommended to prevent CI-AKI. CONCLUSION: More reliable markers of acute kidney injury and new prophylactic strategies are warranted to prevent the incidence of CI-AKI.
Authors: Yen Ta Huang; Yi Ya Chen; Yu Hsien Lai; Chuan Chu Cheng; Tzu Chun Lin; Ying Shih Su; Chin Hung Liu; Pei Chun Lai Journal: Int J Mol Med Date: 2015-11-09 Impact factor: 4.101