Do Catherine
Division of Nephrology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX.
Adv Chronic Kidney Dis. 2017 May;24(3):147-149. doi: 10.1053/j.ackd.2017.03.003.
Intravenous iodinated contrast is used in many contrasted imaging studies ranging from computed tomography to angiography. The risks of contrast-induced nephropathy (CIN) and its incidence have not been clearly defined. Most iodinated contrast media used today are hypertonic compared with serum osmolality and pose biological risks. However, the risk of CIN in the general population may be overestimated. Confounding risk factors may contribute to acute kidney injury other than attributable risk of contrast exposure. In high-risk populations such as in those with CKD, CIN risk may be higher and thus caution should be exerted with contrast exposure. The volumes of contrast should be minimized as much as possible and hemodynamic status should be optimized before contrast administration.
静脉注射碘化造影剂用于许多对比成像研究,从计算机断层扫描到血管造影。对比剂肾病(CIN)的风险及其发生率尚未明确界定。与血清渗透压相比,如今使用的大多数碘化造影剂都是高渗性的,存在生物学风险。然而,一般人群中CIN的风险可能被高估了。除了造影剂暴露的可归因风险外,混杂的风险因素可能导致急性肾损伤。在慢性肾脏病等高危人群中,CIN风险可能更高,因此造影剂暴露时应谨慎。应尽可能减少造影剂的用量,并在注射造影剂前优化血流动力学状态。