Key Considerations regarding the Renal Risks of Iodinated Contrast Media: The Nephrologist's Role.

Acute renal failure Cardiovascular disease Chronic kidney disease Contrast-induced nephropathy Coronary artery disease Interventional cardiology

Journal

Cardiorenal medicine
ISSN: 1664-5502
Titre abrégé: Cardiorenal Med
Pays: Switzerland
ID NLM: 101554863

Informations de publication

Date de publication:
2023
Historique:
received: 27 03 2023
accepted: 23 06 2023
medline: 22 12 2023
pubmed: 28 9 2023
entrez: 27 9 2023
Statut: ppublish

Résumé

The administration of iodinated contrast medium during diagnostic and therapeutic procedures has always been associated with the fear of causing acute kidney injury (AKI) or an exacerbation of chronic kidney disease. This has led, on the one hand, to the deterrence, when possible, of the use of contrast medium (preferring other imaging methods with the risk of loss of diagnostic power), and on the other hand, to the trialling of multiple prophylaxis protocols in an attempt to reduce the risk of kidney injury. A literature review on contrast-induced (CI)-AKI risk mitigation strategies was performed, focussing on the recognition of individual risk factors and on the most recent evidence regarding prophylaxis. Nephrologists can contribute significantly in the CI-AKI context, from the early stages of the decision-making process to stratifying patients by risk, individualising prophylaxis measures based on the risk profile, and ensuring appropriate evaluation of kidney function and damage post-procedure to improve care.

Sections du résumé

BACKGROUND
The administration of iodinated contrast medium during diagnostic and therapeutic procedures has always been associated with the fear of causing acute kidney injury (AKI) or an exacerbation of chronic kidney disease. This has led, on the one hand, to the deterrence, when possible, of the use of contrast medium (preferring other imaging methods with the risk of loss of diagnostic power), and on the other hand, to the trialling of multiple prophylaxis protocols in an attempt to reduce the risk of kidney injury.
SUMMARY
A literature review on contrast-induced (CI)-AKI risk mitigation strategies was performed, focussing on the recognition of individual risk factors and on the most recent evidence regarding prophylaxis.
KEY MESSAGES
Nephrologists can contribute significantly in the CI-AKI context, from the early stages of the decision-making process to stratifying patients by risk, individualising prophylaxis measures based on the risk profile, and ensuring appropriate evaluation of kidney function and damage post-procedure to improve care.

Identifiants

pubmed: 37757781
pii: 000533282
doi: 10.1159/000533282
pmc: PMC10664334
doi:

Substances chimiques

Contrast Media 0

Types de publication

Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

324-331

Informations de copyright

© 2023 The Author(s). Published by S. Karger AG, Basel.

Auteurs

Ravindra Mehta (R)

Division of Nephrology-Hypertension University of California - San Diego, San Diego, California, USA.

David Sorbo (D)

Nephrology, Dialysis and Transplantation Unit, St. Bortolo Hospital, ULSS8 Berica, Vicenza, Italy.

Federico Ronco (F)

Interventional Cardiology - Department of Cardiac Thoracic and Vascular Sciences Ospedale dell'Angelo - Mestre (Venice), Venice, Italy.

Claudio Ronco (C)

Nephrology, Dialysis and Transplantation Unit and International Renal Research Institute, St Bortolo Hospital, ULSS8 Berica, Vicenza, Italy.

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Classifications MeSH