| Strategies to reduce the risk of contrast-induced nephropathy. | |
| | |
MedLine Citation:
|
PMID: 16949381 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
In view of the clinical importance of contrast-induced nephropathy (CIN), numerous potential risk-reduction strategies have been evaluated. Adequate intravenous volume expansion with isotonic crystalloid (1.0-1.5 mL/kg per hr) for 3-12 hours before the procedure and continued for 6-24 hours afterward can lessen the probability of CIN in patients at risk. There are insufficient data on oral fluids (as opposed to intravenous volume expansion) as a CIN-prevention strategy. No adjunctive medical or mechanical treatment has been proved to be efficacious in reducing risk for CIN. Prophylactic hemodialysis and hemofiltration have not been validated as effective strategies. The CIN Consensus Working Panel considered that, of the pharmacologic agents that have been evaluated, theophylline, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), ascorbic acid, and prostaglandin E(1) deserve further evaluation. N-acetylcysteine is not consistently effective in reducing the risk for CIN. Fenoldopam, dopamine, calcium channel blockers, atrial natriuretic peptide, and l-arginine have not been shown to be effective. Use of furosemide, mannitol, or an endothelin receptor antagonist is potentially detrimental. Nephrotoxic drugs should be withdrawn before contrast administration in patients at risk for CIN. |
| | |
Authors:
|
Fulvio Stacul; Andy Adam; Christoph R Becker; Charles Davidson; Norbert Lameire; Peter A McCullough; James Tumlin; |
Publication Detail:
|
Type: Journal Article; Review Date: 2006-03-20 |
Journal Detail:
|
Title: The American journal of cardiology Volume: 98 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2006 Sep |
Date Detail:
|
Created Date: 2006-09-04 Completed Date: 2006-10-12 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 59K-77K Citation Subset: AIM; IM |
Affiliation:
|
Department of Radiology, University of Trieste, Trieste, Italy. fulvio.stacul@aots.sanita.fvg.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Consensus Development Conferences as Topic Contrast Media / adverse effects* Emergencies Fluid Therapy Hemofiltration Humans Hypoglycemic Agents / adverse effects Metformin / adverse effects Renal Dialysis Renal Insufficiency, Acute / chemically induced*, prevention & control* |
| Chemical | |
Reg. No./Substance:
|
0/Contrast Media; 0/Hypoglycemic Agents; 657-24-9/Metformin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Contrast medium use.
Next Document: Sex steroid hormone pathway genes and health-related measures in women of 4 races/ethnicities: the S...