Andreucci Michele
G Ital Nefrol. 2014 Sep-Oct;31(5).
Iodinated radiographic contrast media may cause kidney dysfunction that occurs in particular in patients with pre-existing renal impairment and/or diabetes. This impairment of renal function is called contrast-induced nephropathy (CIN), i.e. an acute renal failure occurring within 24-72 hours after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The pathogenesis of CIN has not been fully elucidated yet. It may be due to several factors, including renal ischaemia, particularly in the renal medulla, formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, tubular epithelial and vascular endothelial injury. CIN can be prevented. For prevention, however, we need to know the risk factors. I have reviewed the pathogenesis and the risk factors for CIN and discussed the measures for its prevention, providing a long list of references which will allow readers to evaluate deeply this iatrogenic disease.
碘化造影剂可能会导致肾功能障碍,这种情况尤其容易发生在已有肾功能损害和/或糖尿病的患者身上。这种肾功能损害被称为造影剂肾病(CIN),即血管内注射碘化造影剂后24至72小时内发生的急性肾衰竭,且不能归因于其他原因。CIN的发病机制尚未完全阐明。它可能由多种因素引起,包括肾缺血,尤其是肾髓质缺血、活性氧(ROS)的形成、一氧化氮(NO)生成减少、肾小管上皮和血管内皮损伤。CIN是可以预防的。然而,要进行预防,我们需要了解其危险因素。我回顾了CIN的发病机制和危险因素,并讨论了其预防措施,提供了一长串参考文献,以便读者深入评估这种医源性疾病。