Department of Internal Medicine, Division of Cardiology, Baylor University Medical Center, Dallas, Texas; Baylor Heart and Vascular Institute, Dallas, Texas; Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas; The Heart Hospital Baylor Plano, Plano, Texas.
Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas.
J Am Coll Cardiol. 2016 Sep 27;68(13):1465-1473. doi: 10.1016/j.jacc.2016.05.099.
Coronary angiography and percutaneous intervention rely on the use of iodinated intravascular contrast for vessel and chamber imaging. Despite advancements in imaging and interventional techniques, iodinated contrast continues to pose a risk of contrast-induced acute kidney injury (CI-AKI) for a subgroup of patients at risk for this complication. There has been a consistent and graded signal of risk for associated outcomes including need for renal replacement therapy, rehospitalization, and death, according to the incidence and severity of CI-AKI. This paper reviews the epidemiology, pathophysiology, prognosis, and management of CI-AKI as it applies to the cardiac catheterization laboratory.
冠状动脉造影和经皮介入治疗依赖于碘造影剂进行血管和腔室成像。尽管影像学和介入技术不断进步,但对于存在这种并发症风险的亚组患者,碘造影剂仍然存在对比剂诱导的急性肾损伤(CI-AKI)的风险。根据 CI-AKI 的发生率和严重程度,与相关结局相关的风险信号一直是一致且分级的,包括需要肾脏替代治疗、再住院和死亡。本文回顾了 CI-AKI 的流行病学、病理生理学、预后和管理,以及其在心脏导管室的应用。