Vandenberghe Wim, Hoste Eric
Department of Intensive Care Medicine, University Hospital Ghent, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium.
Research Foundation-Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium.
F1000Res. 2019 May 29;8. doi: 10.12688/f1000research.16347.1. eCollection 2019.
For decades, when contrast agents are administrated, physicians have been concerned because of the risk of inducing acute kidney injury (AKI). Recent literature questions the existence of AKI induced by contrast, but animal studies clearly showed harmful effects. The occurrence of contrast-associated AKI was likely overestimated in the past because of confounders for AKI. Several strategies have been investigated to reduce contrast-associated AKI but even for the most important one, hydration, there are conflicting data. Even if the occurrence rate of contrast-associated AKI is low, AKI is related to worse outcomes. Therefore, besides limiting contrast agent usage, general AKI preventive measurements should be applied in at-risk patients.
几十年来，当使用造影剂时，医生们一直担心会诱发急性肾损伤（AKI）。近期文献对造影剂诱发的急性肾损伤的存在提出了质疑，但动物研究清楚地显示了其有害影响。过去，由于急性肾损伤的混杂因素，造影剂相关急性肾损伤的发生率可能被高估了。人们已经研究了几种策略来降低造影剂相关急性肾损伤的发生率，但即使是最重要的一种策略——水化，也存在相互矛盾的数据。即使造影剂相关急性肾损伤的发生率很低，但急性肾损伤与更差的预后相关。因此，除了限制造影剂的使用外，还应在高危患者中应用一般的急性肾损伤预防措施。
