McCullough Peter A
Divisions of Cardiology, Nutrition, and Preventive Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Nephron Physiol. 2008;109(4):p61-72. doi: 10.1159/000142938. Epub 2008 Sep 18.
Many radiographic studies and procedures use iodinated contrast media and consequently pose the risk of contrast-induced acute kidney injury (AKI). This is an important complication, which accounts for a significant number of cases of hospital-acquired renal failure associated increased hospital length of stay and increased mortality. Sustained reductions in renal blood flow, hypoxic injury, direct cellular toxicity by the contrast media, and superimposed organ injury are all believed to play a role in this form of AKI. Avoidance of dehydration and multimodality prevention measures may reduce rates of this problem in patients at risk. Contrast-induced AKI is likely to remain a significant challenge for specialists in the future since the patient population is aging, chronic kidney disease and diabetes are coming more common, and use of iodinated contrast is growing.
许多放射学研究和操作都使用碘化造影剂,因此存在造影剂诱发急性肾损伤(AKI)的风险。这是一种重要的并发症,导致大量医院获得性肾衰竭病例,与住院时间延长和死亡率增加相关。肾血流量持续减少、缺氧损伤、造影剂直接细胞毒性以及叠加的器官损伤都被认为在这种形式的急性肾损伤中起作用。避免脱水和采取多模式预防措施可能会降低高危患者出现此问题的发生率。由于患者群体老龄化、慢性肾病和糖尿病越来越普遍,且碘化造影剂的使用不断增加,造影剂诱发的急性肾损伤在未来可能仍将是专家面临的重大挑战。