Krasinski Zbigniew, Krasińska Beata, Olszewska Marta, Pawlaczyk Krzysztof
Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Department of Hypertension, Angiology and Internal Disease, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Diagnostics (Basel). 2020 May 2;10(5):274. doi: 10.3390/diagnostics10050274.
AKI is one of the most common underdiagnosed postoperative complications that can occur after any type of surgery. Contrast-induced nephropathy (CIN) is still poorly defined and due a wide range of confounding individual variables, its risk is difficult to determine. CIN mainly affects patients with underlying chronic kidney disease, diabetes, sepsis, heart failure, acute coronary syndrome and cardiogenic shock. Further research is necessary to better understand pathophysiology of contrast-induced AKI and consequent implementation of effective prevention and therapeutic strategies. Although many therapies have been tested to avoid CIN, the only potent preventative strategy involves aggressive fluid administration and reduction of contrast volume. Regardless of surgical technique-open or endovascular-perioperative AKI is associated with significant morbidity, mortality and cost. Endovascular procedures always require administration of a contrast media, which may cause acute tubular necrosis or renal vascular embolization leading to renal ischemia and as a consequence, contribute to increased number of post-operative AKIs.
急性肾损伤（AKI）是任何类型手术后最常见的未被充分诊断的术后并发症之一。造影剂肾病（CIN）的定义仍不明确，由于存在大量混杂的个体变量，其风险难以确定。CIN主要影响患有潜在慢性肾病、糖尿病、脓毒症、心力衰竭、急性冠状动脉综合征和心源性休克的患者。有必要进行进一步研究，以更好地了解造影剂所致急性肾损伤的病理生理学，并进而实施有效的预防和治疗策略。尽管已经测试了许多疗法来避免CIN，但唯一有效的预防策略是积极补液和减少造影剂用量。无论手术技术是开放手术还是血管内手术，围手术期AKI都与显著的发病率、死亡率和成本相关。血管内手术总是需要使用造影剂，这可能会导致急性肾小管坏死或肾血管栓塞，从而导致肾缺血，进而导致术后急性肾损伤的数量增加。
