Department of Cardiovascular Sciences, Centro Cardiologico Monzino, I.R.C.C.S, University of Milan, Via Parea 4, 20138, Milan, Italy.
Intern Emerg Med. 2012 Oct;7 Suppl 3:S181-3. doi: 10.1007/s11739-012-0803-z.
Radiological procedures utilizing intravascular iodinated contrast media are being widely applied for both diagnostic and therapeutic purposes and represent one of the main causes of contrast-induced nephropathy (CIN) and hospital-acquired renal failure. Although the risk of CIN is low (0.6-2.3 %) in the general population, it may be very high (up to 50 %) in selected subsets, especially in patients with major risk factors such as advanced chronic kidney disease and diabetes mellitus, and in those undergoing emergency percutaneous coronary interventions (PCI). Due to the lack of any effective treatment, prevention of this iatrogenic disease, which is associated with significant in-hospital and long-term morbidity and mortality and increased costs, is the key strategy. However, prevention of CIN continues to elude clinicians and is a main concern during PCI, as patients undergoing these procedures often have multiple comorbidities. The purpose of this study is to examine the pathophysiology, risk factors and clinical course of CIN, as well as the most recent studies dealing with its prevention and potential therapeutic interventions, especially during PCI.
放射学程序利用血管内碘造影剂,广泛应用于诊断和治疗目的,是造影剂肾病(CIN)和医院获得性肾衰竭的主要原因之一。虽然 CIN 的风险在普通人群中较低(0.6-2.3%),但在某些特定亚组中可能非常高(高达 50%),尤其是在有主要危险因素的患者中,如晚期慢性肾脏病和糖尿病,以及接受紧急经皮冠状动脉介入治疗(PCI)的患者。由于缺乏任何有效的治疗方法,预防这种医源性疾病是关键策略,因为它与显著的院内和长期发病率和死亡率以及增加的成本有关。然而,CIN 的预防仍然困扰着临床医生,是 PCI 期间的主要关注点,因为接受这些程序的患者通常有多种合并症。本研究的目的是检查 CIN 的病理生理学、危险因素和临床过程,以及最近关于其预防和潜在治疗干预的研究,特别是在 PCI 期间。