Weinrauch L A, Healy R W, Leland O S, Goldstein H H, Kassissieh S D, Libertino J A, Takacs F J, D'Elia J A
Ann Intern Med. 1977 Jan;86(1):56-9. doi: 10.7326/0003-4819-86-1-56.
Thirteen juvenile-onset diabetics with azotemic diabetic nephropathy (mean serum creatinine level, 6.8 mg/dl) being evaluated fro renal transplantation underwent cardiac catheterization with angiography. All were followed for development of acute renal failure. Twelve (92%) developed some evidence of acute renal failure. Two required potassium exchange resin therapy. Six required dialysis acutely. There were no deaths. All patients who received greater than 65 ml/m2 of iodinated contrast developed acute renal failure. No patient with a hemoglobin value greater than 9.9 g/dl required dialysis or potassium exchange resin. The single patients without acute renal failure received less than 50 ml/m2 of iodinated contrast and had the highest hemoglobin value (12.0 g/dl). No cardiac or angiographic variables were predictive of acute renal failure. In this group at high risk for acute renal failure, radiographic contrast procedures should only be done if the information to be obtained is weighed against the potential for injury.
13名患有氮质血症性糖尿病肾病（平均血清肌酐水平为6.8mg/dl）且正接受肾移植评估的青少年糖尿病患者接受了心脏导管插入术及血管造影。对所有患者进行了急性肾衰竭发生情况的随访。12名患者（92%）出现了急性肾衰竭的某些迹象。2名患者需要使用钾交换树脂疗法。6名患者急性需要透析。无死亡病例。所有接受超过65ml/m²碘化造影剂的患者均发生了急性肾衰竭。血红蛋白值高于9.9g/dl的患者均无需透析或使用钾交换树脂。唯一未发生急性肾衰竭的患者接受的碘化造影剂少于50ml/m²，且血红蛋白值最高（12.0g/dl）。没有心脏或血管造影变量可预测急性肾衰竭。在这个急性肾衰竭高危组中，只有在权衡所获信息与潜在损伤风险后，才应进行放射造影检查。
