Goldenberg Ilan, Matetzky Shlomi
Heart Institute, Sheba Medical Center, Tel Hashomer, Israel.
CMAJ. 2005 May 24;172(11):1461-71. doi: 10.1503/cmaj.1040847.
With the increasing use of contrast media in diagnostic and interventional procedures, nephropathy induced by contrast media has become the third leading cause of hospital-acquired acute renal failure. It is also associated with a significant risk of morbidity and death. The current understanding of the pathogenesis indicates that contrast-medium nephropathy is caused by a combination of renal ischemia and direct toxic effects on renal tubular cells. Patients with pre-existing renal insufficiency, diabetes mellitus and congestive heart failure are at highest risk. Risk factors also include the type and amount of contrast medium administered. Therapeutic prevention strategies are being extensively investigated, but there is still no definitive answer. In this article, we review the current evidence on the causes, pathogenesis and clinical course of contrast-medium nephropathy as well as therapeutic approaches to its prevention evaluated in clinical trials.
随着造影剂在诊断和介入操作中的使用日益增加，造影剂诱发的肾病已成为医院获得性急性肾衰竭的第三大主要原因。它还与较高的发病和死亡风险相关。目前对发病机制的认识表明，造影剂肾病是由肾缺血和对肾小管细胞的直接毒性作用共同引起的。已有肾功能不全、糖尿病和充血性心力衰竭的患者风险最高。危险因素还包括所用造影剂的类型和剂量。治疗性预防策略正在广泛研究中，但仍没有明确答案。在本文中，我们综述了关于造影剂肾病的病因、发病机制和临床过程的现有证据，以及在临床试验中评估的预防其发生的治疗方法。
