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对比剂诱导的急性肾损伤(CI-AKI)——误区与现实。

Contrast Induced Acute Kidney Injury (CI- AKI) - Myths and Realities.

机构信息

Consultant, Department of Renal Sciences, Ivy Hospital, Mohali, Punjab.

Consultant, Institute of Renal Sciences, Department of Nephrology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi.

出版信息

J Assoc Physicians India. 2021 Nov;69(11):11-12.

Abstract

Contrast Induced Acute Kidney Injury (CI-AKI) is one of the most common causes of acute kidney injury in hospitalized patients. These days, contrast agents are widely being used in both cardiology and radiology procedures. Old age, history of diabetes, heart failure, proteinuria and low blood pressure are some important risk factors in the pathogenesis of CI-AKI. Apart from risk stratification and the use of low and iso-osmolar contrast agents, intravenous fluid hydration with crystalloids is the only recommended strategy for the prevention of CI-AKI. Agents like N-acetylcysteine (NAC), atrial natriuretic peptide, ascorbic acid, theophylline, and fenoldopam have failed to show any proven beneficial role in the prevention of CI-AKI. Though hemodialysis is still being perceived by many clinicians as the modality for contrast removal but prophylactic hemodialysis is now not recommended for the prevention of CI-AKI.

摘要

对比剂诱导的急性肾损伤(CI-AKI)是住院患者急性肾损伤的最常见原因之一。如今,造影剂在心脏病学和放射学程序中被广泛使用。高龄、糖尿病史、心力衰竭、蛋白尿和低血压是 CI-AKI 发病机制中的一些重要危险因素。除了风险分层和使用低渗和等渗造影剂外,静脉补液晶体液水化是预防 CI-AKI 的唯一推荐策略。N-乙酰半胱氨酸(NAC)、心房利钠肽、抗坏血酸、茶碱和非诺多泮等药物在预防 CI-AKI 方面均未能显示出任何有益作用。虽然许多临床医生仍然认为血液透析是去除造影剂的一种方式,但预防性血液透析现在不推荐用于预防 CI-AKI。

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