Department of Internal Medicine, Beaumont Hospital-Royal Oak, 3601 W 13 Mile Road, Royal Oak, MI 48073, USA.
Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, 2A 192F, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5853, USA.
Interv Cardiol Clin. 2020 Jul;9(3):403-407. doi: 10.1016/j.iccl.2020.02.011. Epub 2020 May 12.
Contrast-induced acute kidney injury is a common complication in patients undergoing invasive procedures and is associated with increased mortality and morbidity. There is no effective approach to the management of this complication, and prevention remains of paramount importance. The 3 pillars of prevention are identification of high-risk patients, appropriate hydration before and after contrast exposure, eGFR-based contrast dosing and use of ultra-low contrast volume in high-risk patients. Most evidence supporting these practices is derived from patients undergoing coronary angiography or percutaneous coronary intervention but these basic principles can be applied to most patients undergoing contrast-based procedures in the catheterization laboratory.
对比剂相关急性肾损伤是接受有创性操作的患者常见的并发症，与死亡率和发病率增加相关。目前对于该并发症的处理方法尚无有效手段，预防仍然至关重要。预防的 3 个支柱是识别高危患者、在造影剂暴露前后进行适当水化、基于 eGFR 的造影剂剂量以及在高危患者中使用超低造影剂用量。支持这些实践的大多数证据来自接受冠状动脉造影或经皮冠状动脉介入治疗的患者，但这些基本原则可以应用于导管室中接受基于造影剂的大多数患者。
