Medicine/Nephrology, Baylor College of Medicine, Houston, Texas 77030, USA.
Clin Cardiol. 2010 Feb;33(2):62-6. doi: 10.1002/clc.20687.
Contrast-induced nephropathy, also known as contrast-induced acute kidney injury, is associated with rapid and often irreversible decline in kidney function following the administration of iodinated contrast agents. Contrast-induced nephropathy is the third leading cause of acute kidney injury in hospitalized patients, and substantially increases mortality, morbidity, and length of hospitalization. Contrast-induced nephropathy follows a predictable time of onset and is potentially preventable. It has been the subject of numerous studies addressing characteristics of the populations at risk and prophylactic strategies. This evidence-based review summarizes recent literature and provides a nephrologists' perspective on contrast-induced nephropathy, focusing on: the pathophysiology of contrast-induced nephropathy; identification of populations at risk; correlation between contrast-induced nephropathy and the type of contrast agent used; and finally, measures to prevent contrast-induced nephropathy, including intravenous fluids, sodium bicarbonate, N-acetylcysteine, and hemofiltration/hemodialysis.
对比剂肾病，也称为对比剂诱导的急性肾损伤，是指在使用碘造影剂后肾功能迅速且常不可逆下降。对比剂肾病是住院患者急性肾损伤的第三大主要原因，显著增加了死亡率、发病率和住院时间。对比剂肾病的发病时间是可以预测的，且具有潜在可预防性。已有大量研究探讨了风险人群的特征和预防策略。本循证综述总结了近期文献，并从肾脏病学家的角度对对比剂肾病进行了综述，重点关注：对比剂肾病的病理生理学；风险人群的识别；对比剂肾病与所用造影剂类型的相关性；以及预防对比剂肾病的措施，包括静脉补液、碳酸氢钠、N-乙酰半胱氨酸和血液滤过/血液透析。
