Buhaescu I, Izzedine H
Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA.
Int J Clin Pract. 2008 Jul;62(7):1113-8. doi: 10.1111/j.1742-1241.2007.01582.x. Epub 2008 Jan 23.
Because of the well-documented risk of acute renal failure with the iodinated contrast media in patients with underlying chronic renal insufficiency, the use of intravenous gadolinium-based contrast media in magnetic resonance imaging for diagnostic and interventional radiology procedures has become a well-established clinical practice in the recent years. Although originally thought to be safe and lack the nephrotoxic effects of iodinated contrast media, gadolinium-based contrast media have recently been reported to induce a usually reversible decrease of glomerular filtration rate in a high-risk population group, especially in patients with altered baseline renal function. Here we present the current experimental and clinical evidence on this new challenge for the nephrologist, gadolinium-induced nephrotoxicity in patients with chronic kidney disease.
由于有充分记录表明,基础慢性肾功能不全患者使用含碘造影剂会有急性肾衰竭风险,近年来,在磁共振成像的诊断和介入放射学程序中使用静脉注射钆基造影剂已成为一种成熟的临床实践。尽管钆基造影剂最初被认为是安全的,且没有含碘造影剂的肾毒性作用,但最近有报道称,在高危人群中,尤其是基线肾功能改变的患者中,钆基造影剂会导致肾小球滤过率通常可逆性下降。在此,我们展示了针对肾病学家面临的这一新挑战——慢性肾病患者钆诱导的肾毒性的当前实验和临床证据。