Swapnil Hiremath1, Juan Carlos Q Velez. 1. Department of Medicine, University of Ottawa Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada Department of Nephrology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA Ochsner Clinical School/The University of Queensland, Brisbane, Australia.
Abstract
PURPOSE OF REVIEW: In recent years, doubt has been cast on the existence of contrast-induced acute kidney injury. The skepticism has stemmed from observational studies from large administrative healthcare databases. Although they correctly call that contrast-induced acute kidney injury is less common than previously thought, they cannot completely exclude selection bias. RECENT FINDINGS: Though less common than previously thought, contrast-induced acute kidney injury still exists. The only prophylactic method that remains valid is that of isotonic volume expansion, which is still deemed beneficial in high-risk patients. N-acetylcysteine and sodium bicarbonate are ineffective and their use should be abandoned. SUMMARY: Contrast-induced kidney injury should be defined based on clinical grounds, not merely on biochemical numbers. More research to validate a clinical definition is necessary in order to accurately re-examine its incidence.
PURPOSE OF REVIEW: In recent years, doubt has been cast on the existence of contrast-induced acute kidney injury. The skepticism has stemmed from observational studies from large administrative healthcare databases. Although they correctly call that contrast-induced acute kidney injury is less common than previously thought, they cannot completely exclude selection bias. RECENT FINDINGS: Though less common than previously thought, contrast-induced acute kidney injury still exists. The only prophylactic method that remains valid is that of isotonic volume expansion, which is still deemed beneficial in high-risk patients. N-acetylcysteine and sodium bicarbonate are ineffective and their use should be abandoned. SUMMARY: Contrast-induced kidney injury should be defined based on clinical grounds, not merely on biochemical numbers. More research to validate a clinical definition is necessary in order to accurately re-examine its incidence.
Authors: D Blair Macdonald; Casey D Hurrell; Andreu F Costa; Matthew D F McInnes; Martin O'Malley; Brendan J Barrett; Pierre Antoine Brown; Edward G Clark; Anastasia Hadjivassiliou; Iain Donald Craik Kirkpatrick; Jeremy Rempel; Paul Jeon; Swapnil Hiremath Journal: Can J Kidney Health Dis Date: 2022-05-24
Authors: Nivetha Subramanian; Jialin Han; Nicholas J Leeper; Elsie G Ross; Maria E Montez-Rath; Tara I Chang Journal: Am J Nephrol Date: 2021-05-06 Impact factor: 4.605