Efstratiadis G, Pateinakis P, Tambakoudis G, Pantzaki A, Economidou D, Memmos D
Department of Nephrology, Aristotle University of Thessaloniki, and Department of Pathology, Hippokration General Hospital, Thessaloniki, Greece.
Hippokratia. 2008 Apr;12(2):87-93.
Contrast media administration during diagnostic and invasive procedures in high risk patients for nephrotoxicity is a common problem in clinical practice. The mechanisms involved in renal function impairment after contrast media administration are not precisely known but are intensively investigated, and new data have emerged in the literature lately. We present the case of a 72-year old male patient with diabetic nephropathy to whom a new generation iso-osmolar contrast medium (iodixanol) was administered during intravenous pyelography. Due to the contrast agent administration, the patient developed irreversible acute renal failure and became dialysis-dependent. This case suggests that even new generation contrast media (including iodixanol) may be severely nephrotoxic, when administered to high risk patients. Additionally we review the complex mechanisms involved in pathogenesis of contrast media nephrotoxicity.
在具有肾毒性高风险的患者进行诊断性和侵入性操作期间给予造影剂是临床实践中的常见问题。造影剂给药后肾功能损害所涉及的机制尚不完全清楚，但正在深入研究，最近文献中也出现了新的数据。我们报告一例72岁男性糖尿病肾病患者，在静脉肾盂造影期间给予了新一代等渗造影剂（碘克沙醇）。由于给予造影剂，该患者发生了不可逆的急性肾衰竭并开始依赖透析。该病例表明，即使是新一代造影剂（包括碘克沙醇），给予高风险患者时也可能具有严重肾毒性。此外，我们还综述了造影剂肾毒性发病机制中涉及的复杂机制。
