McCullough Peter A, Adam Andy, Becker Christoph R, Davidson Charles, Lameire Norbert, Stacul Fulvio, Tumlin James
William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Am J Cardiol. 2006 Sep 18;98(6A):5K-13K. doi: 10.1016/j.amjcard.2006.01.019. Epub 2006 Feb 10.
Contrast-induced nephropathy (CIN), usually defined as an increase in serum creatinine of 0.5 mg/dL (44.2 mumol/L), or a 25% increase from the baseline value 48 hours after the procedure, is a common and potentially serious complication of the use of iodinated contrast media in patients at risk of acute renal injury. It is an important cause of hospital-acquired renal failure, responsible for approximately 11% of cases. CIN may be difficult to distinguish from cholesterol embolization, another cause of postprocedure renal impairment. The reported incidence of CIN varies depending on the patient population studied. The impact of postprocedural renal impairment on clinical outcomes has been evaluated most extensively in patients undergoing percutaneous coronary intervention. CIN is associated with increased mortality both in hospital and at 1 year. A higher incidence of in-hospital and late cardiovascular events, as well as longer hospital stays, has been reported in patients developing CIN. In a small proportion of patients, CIN is severe enough to require dialysis, and these patients have a particularly poor prognosis. Many of the risk markers for CIN are also predictive of a worse prognosis.
对比剂肾病（CIN）通常定义为血清肌酐升高0.5mg/dL（44.2μmol/L），或在检查后48小时较基线值升高25%，它是急性肾损伤风险患者使用碘化造影剂时常见且可能严重的并发症。它是医院获得性肾衰竭的重要原因，约占病例的11%。CIN可能难以与胆固醇栓塞相区分，后者是检查后肾功能损害的另一个原因。CIN的报告发病率因所研究的患者群体而异。在接受经皮冠状动脉介入治疗的患者中，对检查后肾功能损害对临床结局的影响进行了最广泛的评估。CIN与住院期间及1年时死亡率增加相关。据报道，发生CIN的患者住院期间和晚期心血管事件的发生率更高，住院时间也更长。在一小部分患者中，CIN严重到需要透析，这些患者的预后特别差。许多CIN的风险标志物也预示着更差的预后。
