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使用碘基造影剂进行肾移植导管动脉造影后对比剂肾病的发生率

Incidence of Contrast-Induced Nephropathy After Renal Graft Catheter Arteriography Using Iodine-Based Contrast Medium.

作者信息

Fananapazir Ghaneh, Troppmann Christoph, Corwin Michael T, Bent Chris K, Vu Catherine T, Lamba Ramit

机构信息

1 Department of Radiology, University of California Davis Medical Center, 4860 Y St, Ste 3100, Sacramento, CA 95817.

2 Department of Surgery, University of California Davis Medical Center, Sacramento, CA.

出版信息

AJR Am J Roentgenol. 2016 Apr;206(4):783-6. doi: 10.2214/AJR.15.15501. Epub 2016 Feb 11.

Abstract

OBJECTIVE

The objective of our study was to assess the incidence of contrast-induced nephropathy (CIN), dialysis, and graft loss after direct intraarterial infusion of iodine-based contrast medium (CM) in renal allograft recipients.

MATERIALS AND METHODS

One hundred patients underwent renal graft catheter arteriography between 2006 and 2014. CIN was defined as an increase in serum creatinine value of 0.5 mg/dL or more above the creatinine value before arteriography. CIN could be assessed in 37 patients with creatinine levels obtained before arteriography and 24-72 hours after arteriography. Dialysis requirement and renal allograft loss at 30 days after the procedure were recorded in all 100 patients.

RESULTS

In the 37 patients who could be assessed for CIN, three patients (8%) met the criteria for CIN. In a subgroup analysis, there was an increased incidence of CIN in patients undergoing angiography alone (25%) compared with those in the angioplasty and stenting group (0%) (p = 0.028). At 30 days after the procedure, none (0/100) of the patients required dialysis or had graft failure.

CONCLUSION

In a cohort of patients with a single renal allograft undergoing renal graft catheter arteriography using iodine-based CM, the overall incidence of CIN was low and no major adverse outcomes were noted at 30 days after the procedure. However, in a subgroup analysis, the patients who underwent arteriography alone-that is, without angioplasty or stenting-had a statistically significant higher rate of CIN.

摘要

目的

我们研究的目的是评估肾移植受者直接动脉内注入碘造影剂(CM)后对比剂肾病(CIN)、透析及移植肾失功的发生率。

材料与方法

2006年至2014年间,100例患者接受了移植肾导管动脉造影。CIN定义为血清肌酐值较动脉造影前肌酐值升高0.5mg/dL或更多。对37例在动脉造影前及造影后24 - 72小时测得肌酐水平的患者评估CIN。记录了所有100例患者术后30天的透析需求及移植肾失功情况。

结果

在可评估CIN的37例患者中,3例(8%)符合CIN标准。亚组分析显示,单纯接受血管造影的患者CIN发生率(25%)高于血管成形术及支架置入组(0%)(p = 0.028)。术后30天,无一例(0/100)患者需要透析或发生移植肾失功。

结论

在一组接受基于碘的CM进行移植肾导管动脉造影的单肾移植患者中,CIN的总体发生率较低,且术后30天未观察到重大不良结局。然而,亚组分析显示,单纯接受动脉造影(即未行血管成形术或支架置入)的患者CIN发生率在统计学上显著更高。

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