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对比剂肾病

Contrast-induced Nephropathy.

作者信息

Mohammed Nazar M A, Mahfouz Ahmed, Achkar Katafan, Rafie Ihsan M, Hajar Rachel

机构信息

Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

Heart Views. 2013 Jul;14(3):106-16. doi: 10.4103/1995-705X.125926.

Abstract

Contrast-induced nephropathy (CIN) is a serious complication of angiographic procedures resulting from the administration of contrast media (CM). It is the third most common cause of hospital acquired acute renal injury and represents about 12% of the cases. CIN is defined as an elevation of serum creatinine (Scr) of more than 25% or ≥0.5 mg/dl (44 μmol/l) from baseline within 48 h. More sensitive markers of renal injury are desired, therefore, several biomarkers of tubular injury are under evaluation. Multiple risk factors may contribute to the development of CIN; these factors are divided into patient- and procedure-related factors. Treatment of CIN is mainly supportive, consisting mainly of careful fluid and electrolyte management, although dialysis may be required in some cases. The available treatment option makes prevention the corner stone of management. This article will review the recent evidence concerning CIN incidence, diagnosis, and prevention strategies as well as its treatment and prognostic implications.

摘要

对比剂肾病(CIN)是血管造影术的一种严重并发症,由使用对比剂(CM)引起。它是医院获得性急性肾损伤的第三大常见原因,约占病例的12%。CIN的定义为在48小时内血清肌酐(Scr)较基线水平升高超过25%或≥0.5mg/dl(44μmol/l)。因此,需要更敏感的肾损伤标志物,目前正在评估几种肾小管损伤的生物标志物。多种危险因素可能导致CIN的发生;这些因素分为与患者相关和与手术相关的因素。CIN的治疗主要是支持性的,主要包括仔细的液体和电解质管理,尽管在某些情况下可能需要透析。现有的治疗选择使预防成为管理的基石。本文将综述有关CIN发病率、诊断、预防策略及其治疗和预后意义的最新证据。

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