Preventing radiocontrast-induced nephropathy in chronic kidney disease patients undergoing coronary angiography

Radiocontrast-induced nephropathy(RCIN) is an acute and severe complication after coronary angiography,particularly for patients with pre-existing chronic kidney disease(CKD).It has been associated with both short-and long-term adverse outcomes,including the need for renal replacement therapy,increa...

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Published inWorld journal of cardiology Vol. 4; no. 5; pp. 157 - 172
Main Authors Hung, Yao-Min, Lin, Shoa-Lin, Hung, Shih-Yuan, Huang, Wei-Chun, Wang, Paul Yung-Pou
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 26.05.2012
Subjects
Acute
angiography
Contrast
Coronary
Guidelines For Clinical Practice
injury
kidney
media
N-acetylcysteine
nephropathy
Radiocontrastinduced
Coronary angiography
Radiocontrast-induced nephropathy
Acute kidney injury
Contrast media
N-acetylcysteine
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Summary:Radiocontrast-induced nephropathy(RCIN) is an acute and severe complication after coronary angiography,particularly for patients with pre-existing chronic kidney disease(CKD).It has been associated with both short-and long-term adverse outcomes,including the need for renal replacement therapy,increased length of hospital stay,major cardiac adverse events,and mortality.RCIN is generally defined as an increase in serum creatinine concentration of 0.5 mg/dL or 25%above baseline within 48 h after contrast administration.There is no effective therapy once injury has occurred,therefore,prevention is the cornerstone for all patients at risk for acute kidney injury(AKI).There is a small but growing body of evidence that prevention of AKI is associated with a reduction in later adverse outcomes.The optimal strategy for preventing RCIN has not yet been established.This review discusses the principal risk factors for RCIN,evaluates and summarizes the evidence for RCIN prophylaxis,and proposes recommendations for preventing RCIN in CKD patients undergoing coronary angiography.
Bibliography:Yao-Min Hung,Division of Nephrology,Jiannren Hospital,Kaohsiung 813,Taiwan,China Shoa-Lin Lin,Wei-Chun Huang,Division of Cardiology,Kaohsiung Veterans General Hospital,Kaohsiung 813,Taiwan,China Shoa-Lin Lin,Wei-Chun Huang,National Yang-Ming University,Taipei 112,Taiwan,China Shoa-Lin Lin,Division of Cardiology,Department of Internal Medicine,Yuan’s General Hospital,Kaohsiung 802,Taiwan,China Shih-Yuan Hung,Division of Nephrology,Department of Internal Medicine,E-Da Hospital,Kaohsiung,824,Taiwan,China Shih-Yuan Hung,Department of Health Management,I-Shou University,Kaohsiung 824,Taiwan,China Paul Yung-Pou Wang,Division of Nephrology,Kaiser Permanente Baldwin Park Medical Center,Baldwin Park,CA 91706,United States
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Correspondence to: Shoa-Lin Lin, MD, Division of Cardiology, Department of Internal Medicine, Yuan’s General Hospital, No. 162, Chen-Kung 1st road, Ling-Ya District, Kaohsiung 802, Taiwan, China. lingoodman@yahoo.com.tw
Author contributions: Hung YM and Lin SL developed the plan of the article and were the primary writers; Hung SY and Huang WC contributed to the data collection and writing the Tables of the manuscript; Wang PYP assisted in critical reviewing and advisement of this article.
Telephone: +886-77352884 Fax: +886-72691506
ISSN:1949-8462
1949-8462
DOI:10.4330/wjc.v4.i5.157