Al-Ghonaim Mohammed, Pannu Neesh
Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada.
Tech Vasc Interv Radiol. 2006 Jun;9(2):42-9. doi: 10.1053/j.tvir.2006.12.002.
Contrast-induced nephropathy (CIN) is a well-known complication of therapeutic and diagnostic procedures requiring contrast administration and accounts for 10 to 12% of acute renal failure in hospitalized patients. Although the incidence of this complication is relatively low, its consequences can be catastrophic. The development of CIN is associated with increased hospital length of stay, an increased requirement for acute dialysis, and an increased risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure, and volume of administered contrast are all associated with a risk of developing CIN. Despite a large number of clinical trials that have evaluated prophylaxis strategies for CIN, only the use of hemofiltration and N-acetylcysteine (NAC) in specific subgroups of patients have been shown to reduce dialysis requirement and mortality in patients undergoing angiographic procedures. In this review we will discuss the epidemiology and the risk factors for CIN and the evidence for commonly employed prophylaxis strategies, and we will provide general recommendations with respect to CIN prevention and management.
造影剂肾病（CIN）是需要使用造影剂的治疗和诊断程序中一种广为人知的并发症，占住院患者急性肾衰竭的10%至12%。尽管这种并发症的发生率相对较低，但其后果可能是灾难性的。CIN的发生与住院时间延长、急性透析需求增加以及死亡风险增加有关。既往存在的肾功能不全、年龄、糖尿病、充血性心力衰竭以及造影剂用量均与发生CIN的风险相关。尽管有大量临床试验评估了CIN的预防策略，但仅在特定亚组患者中使用血液滤过和N-乙酰半胱氨酸（NAC）已被证明可减少接受血管造影术患者的透析需求和死亡率。在本综述中，我们将讨论CIN的流行病学、危险因素以及常用预防策略的证据，并就CIN的预防和管理提供一般性建议。
