Wiora J, Westenfeld R
Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Internist (Berl). 2019 Sep;60(9):996-1003. doi: 10.1007/s00108-019-0651-2.
Iodinated contrast is essential for diagnosis and treatment in contemporary interventional cardiology. An important complication of percutaneous intervention is contrast-induced nephropathy, which is associated with increased morbidity and mortality, while prolonged hospitalization is responsible for economic consequences.
This article reviews the definition of contrast-induced nephropathy, the role of biomarkers in early diagnosis to identify high-risk patients and potential therapeutic options for preventing acute nephropathy.
The optimization of patients' circulating volume remains the main aspect for preventing contrast-induced nephropathy, as recent studies confirm. Several medications are known to be nephrotoxic, whereas several are nephroprotective and the subject of recent research.
Interventions to improve outcomes of established acute kidney injury have not been developed as yet. Prevention and early diagnosis are relevant factors in clinical management. It is important to identify patients at risk and to treat them preemptively.
碘造影剂在当代介入心脏病学的诊断和治疗中至关重要。经皮介入的一个重要并发症是造影剂肾病,它与发病率和死亡率增加相关,而住院时间延长会带来经济后果。
本文综述造影剂肾病的定义、生物标志物在早期诊断以识别高危患者中的作用以及预防急性肾病的潜在治疗选择。
正如最近的研究所证实的,优化患者的循环血容量仍然是预防造影剂肾病的主要方面。已知几种药物具有肾毒性,而几种药物具有肾保护作用且是近期研究的主题。
改善已确诊急性肾损伤结局的干预措施尚未开发出来。预防和早期诊断是临床管理中的相关因素。识别高危患者并对其进行预防性治疗很重要。