J Wiora1, R Westenfeld2. 1. Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland. 2. Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland. ralf.westenfeld@med.uni-duesseldorf.de.
Abstract
BACKGROUND: Iodinated contrast is essential for diagnosis and treatment in contemporary interventional cardiology. An important complication of percutaneous intervention is contrast-induced nephropathy, which is associated with increased morbidity and mortality, while prolonged hospitalization is responsible for economic consequences. OBJECTIVES: This article reviews the definition of contrast-induced nephropathy, the role of biomarkers in early diagnosis to identify high-risk patients and potential therapeutic options for preventing acute nephropathy. CURRENT DATA: The optimization of patients' circulating volume remains the main aspect for preventing contrast-induced nephropathy, as recent studies confirm. Several medications are known to be nephrotoxic, whereas several are nephroprotective and the subject of recent research. CONCLUSION: Interventions to improve outcomes of established acute kidney injury have not been developed as yet. Prevention and early diagnosis are relevant factors in clinical management. It is important to identify patients at risk and to treat them preemptively.
BACKGROUND: Iodinated contrast is essential for diagnosis and treatment in contemporary interventional cardiology. An important complication of percutaneous intervention is contrast-induced nephropathy, which is associated with increased morbidity and mortality, while prolonged hospitalization is responsible for economic consequences. OBJECTIVES: This article reviews the definition of contrast-induced nephropathy, the role of biomarkers in early diagnosis to identify high-risk patients and potential therapeutic options for preventing acute nephropathy. CURRENT DATA: The optimization of patients' circulating volume remains the main aspect for preventing contrast-induced nephropathy, as recent studies confirm. Several medications are known to be nephrotoxic, whereas several are nephroprotective and the subject of recent research. CONCLUSION: Interventions to improve outcomes of established acute kidney injury have not been developed as yet. Prevention and early diagnosis are relevant factors in clinical management. It is important to identify patients at risk and to treat them preemptively.
Authors: Jean-Francois Dorval; Simon R Dixon; Richard B Zelman; Charles J Davidson; Robert Rudko; Frederic S Resnic Journal: Int J Cardiol Date: 2011-12-26 Impact factor: 4.164
Authors: Beth A Bartholomew; Kishore J Harjai; Srinivas Dukkipati; Judith A Boura; Michael W Yerkey; Susan Glazier; Cindy L Grines; William W O'Neill Journal: Am J Cardiol Date: 2004-06-15 Impact factor: 2.778
Authors: Jeremiah R Brown; James T DeVries; Winthrop D Piper; John F Robb; Michael J Hearne; Peter M Ver Lee; Mirle A Kellet; Mathew W Watkins; Thomas J Ryan; M Theodore Silver; Cathy S Ross; Todd A MacKenzie; Gerald T O'Connor; David J Malenka Journal: Am Heart J Date: 2007-11-26 Impact factor: 4.749
Authors: Roxana Mehran; Eve D Aymong; Eugenia Nikolsky; Zoran Lasic; Ioannis Iakovou; Martin Fahy; Gary S Mintz; Alexandra J Lansky; Jeffrey W Moses; Gregg W Stone; Martin B Leon; George Dangas Journal: J Am Coll Cardiol Date: 2004-10-06 Impact factor: 24.094
Authors: Linda F Fried; William Duckworth; Jane Hongyuan Zhang; Theresa O'Connor; Mary Brophy; Nicholas Emanuele; Grant D Huang; Peter A McCullough; Paul M Palevsky; Stephen Seliger; Stuart R Warren; Peter Peduzzi Journal: Clin J Am Soc Nephrol Date: 2008-12-31 Impact factor: 8.237
Authors: Warren K Laskey; Charles Jenkins; Faith Selzer; Oscar C Marroquin; Robert L Wilensky; Ruchira Glaser; Howard A Cohen; David R Holmes Journal: J Am Coll Cardiol Date: 2007-07-30 Impact factor: 24.094