Berg K J
Medical Department, The National Hospital (Rikshospitalet), University of Oslo, Norway.
Scand J Urol Nephrol. 2000 Oct;34(5):317-22. doi: 10.1080/003655900750048341.
The numbers of contrast media (CM)-enhanced examinations are increasing. The annual sale of iodine for CM now represents 60 million CM doses a year world-wide. In spite of improvements in chemical structure, CM are still the third leading cause of hospital-acquired acute renal failure. The definition of contrast nephropathy (CN) is discussed, as well as the mechanisms involved in the pathogenesis. Low osmolar contrast media (LOCM) are less nephrotoxic than high osomolar contrast media (HOCM) and cause fewer osmotoxic side-effects such as pain and heat sensations. The non-ionic dimeric contrast media which are iso-osmolar to plasma (IOCM) cause even fewer haemodynamic side-effects and result in better opacification of the urinary tract than LOCM. The nephrotoxicity of IOCM is low. The risk factors for CN and methods for prevention of CN are discussed.
造影剂（CM）增强检查的数量正在增加。目前，用于CM的碘的年销售量在全球范围内相当于每年6000万剂CM。尽管化学结构有所改进，但CM仍是医院获得性急性肾衰竭的第三大主要原因。本文讨论了对比剂肾病（CN）的定义以及发病机制中涉及的机制。低渗造影剂（LOCM）的肾毒性低于高渗造影剂（HOCM），并且引起的渗透毒性副作用（如疼痛和热感）较少。与血浆等渗的非离子二聚体造影剂（IOCM）引起的血流动力学副作用甚至更少，并且与LOCM相比，能使尿路显影更好。IOCM的肾毒性较低。本文还讨论了CN的危险因素和预防CN的方法。
