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==Overview==
==Overview==
Four factors have been associated with an increased risk of contrast-induced nephropathy: ''pre-existing [[renal insufficiency]]'', ''pre-existing [[diabetes]]'', ''age'', ''Volume of CM'', and ''reduced intravascular volume''.<ref name="pmid9375704">{{cite journal | author=McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW | title=Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality | journal=Am J Med | year=1997 | pages=368-75 | volume=103 | issue=5  | id=PMID 9375704}}</ref><ref name="pmid10334456">{{cite journal | author=Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr | title=ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions | journal=J Am Coll Cardiol | year=1999 | pages=1756-824 | volume=33 | issue=6  | id=PMID 10334456}}</ref> A '''[[clinical prediction rule]]''' is available to estimate probability of nephropathy (increase ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 h)<ref name="pmid15464318">{{cite journal |author=Mehran R, Aymong ED, Nikolsky E, ''et al'' |title=A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation |journal=J. Am. Coll. Cardiol. |volume=44 |issue=7 |pages=1393–9 |year=2004 |pmid=15464318 |doi=10.1016/j.jacc.2004.06.068}}</ref>:
Four factors have been associated with an increased risk of contrast-induced nephropathy: ''pre-existing [[renal insufficiency]]'', ''pre-existing [[diabetes]]'', ''age'', ''Volume of CM'', and ''reduced intravascular volume''.<ref name="pmid9375704">{{cite journal | author=McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW | title=Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality | journal=Am J Med | year=1997 | pages=368-75 | volume=103 | issue=5  | id=PMID 9375704}}</ref><ref name="pmid10334456">{{cite journal | author=Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr | title=ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions | journal=J Am Coll Cardiol | year=1999 | pages=1756-824 | volume=33 | issue=6  | id=PMID 10334456}}</ref> A '''[[clinical prediction rule]]''' is available to estimate probability of nephropathy (increase ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 h)<ref name="pmid15464318">{{cite journal |author=Mehran R, Aymong ED, Nikolsky E, ''et al'' |title=A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation |journal=J. Am. Coll. Cardiol. |volume=44 |issue=7 |pages=1393–9 |year=2004 |pmid=15464318 |doi=10.1016/j.jacc.2004.06.068}}</ref>


==Risk Factors:==
==Risk Factors:==


===Pre-existing renal disease===
===Pre-existing renal disease===
Pre-existing renal disease with an elevated level of serum creatinine considered to be the most crucial risk factor in the development of CIN.  The incidence of CIN in patients with underlying chronic kidney disease is extremely high, ranging from 14.8 to 55%<ref name="pmid12010907">{{cite journal| author=Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ et al.| title=Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. | journal=Circulation | year= 2002 | volume= 105 | issue= 19 | pages= 2259-64 | pmid=12010907 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12010907  }} </ref> <ref name="pmid9375704">{{cite journal| author=McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW| title=Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. | journal=Am J Med | year= 1997 | volume= 103 | issue= 5 | pages= 368-75 | pmid=9375704 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9375704  }} </ref> <ref name="pmid11285590">{{cite journal| author=Gruberg L, Mehran R, Dangas G, Mintz GS, Waksman R, Kent KM et al.| title=Acute renal failure requiring dialysis after percutaneous coronary interventions. | journal=Catheter Cardiovasc Interv | year= 2001 | volume= 52 | issue= 4 | pages= 409-16 | pmid=11285590 | doi=10.1002/ccd.1093 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11285590  }} </ref>
In one study, CIN occurred in one-third of 439 consecutive patients who underwent PCI despite pre-procedure hydration and the use of non-ionic CM.<ref name="pmid11285590">{{cite journal| author=Gruberg L, Mehran R, Dangas G, Mintz GS, Waksman R, Kent KM et al.| title=Acute renal failure requiring dialysis after percutaneous coronary interventions. | journal=Catheter Cardiovasc Interv | year= 2001 | volume= 52 | issue= 4 | pages= 409-16 | pmid=11285590 | doi=10.1002/ccd.1093 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11285590  }} </ref>


Although baseline creatinine is not reliable enough for identification of patients at risk for CIN, this is because serum creatinine value varies with age, muscle mass, and gender, one of the studies shown that the higher the baseline creatinine value, the greater is the risk of CIN.
:If baseline plasma creatinine level is less than or equal to 1.2 mg/dl, the risk of CIN is only 2%


:Values of creatinine in the range of 1.4–1.9 mg/dl, the risk of CIN compared with that in the previous group increases fivefold (10.4%)


:Patients with baseline creatinine level more than 2.0 mg/dl, more than half of them (62%) subsequently develop CIN.<ref name="pmid1405611">{{cite journal| author=Hall KA, Wong RW, Hunter GC, Camazine BM, Rappaport WA, Smyth SH et al.| title=Contrast-induced nephrotoxicity: the effects of vasodilator therapy. | journal=J Surg Res | year= 1992 | volume= 53 | issue= 4 | pages= 317-20 | pmid=1405611 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1405611  }} </ref>


===Diabetes mellitus===
Due to high prevalence of diabetes in the general population, and the ability of the disease to cause a broad spectrum of cardiovascular diseases that require radiological procedures using CM, diabetic patients represent a significant proportion of those undergoing contrast exposure with incidence of CIN varies from 5.7 to 29.4%.<ref name="pmid15276092">{{cite journal| author=Nikolsky E, Mehran R, Turcot D, Aymong ED, Mintz GS, Lasic Z et al.| title=Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention. | journal=Am J Cardiol | year= 2004 | volume= 94 | issue= 3 | pages= 300-5 | pmid=15276092 | doi=10.1016/j.amjcard.2004.04.023 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15276092  }} </ref>  The rates of CIN are usually comparable to those of a non-diabetic population in diabetics patients with preserved renal function.<ref name="pmid9169676">{{cite journal| author=Lasser EC, Lyon SG, Berry CC| title=Reports on contrast media reactions: analysis of data from reports to the U.S. Food and Drug Administration. | journal=Radiology | year= 1997 | volume= 203 | issue= 3 | pages= 605-10 | pmid=9169676 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9169676  }} </ref>
===Age===
The reasons for higher risk to develop CIN in elderly were not studied specifically and probably are multifactorial, including age-related changes in renal function (diminished glomerular filtration rate, tubular secretion, and concentrating ability).  Several studies proved that older age is an independent predictor of CIN.<ref name="pmid2010458">{{cite journal| author=Gussenhoven MJ, Ravensbergen J, van Bockel JH, Feuth JD, Aarts JC| title=Renal dysfunction after angiography; a risk factor analysis in patients with peripheral vascular disease. | journal=J Cardiovasc Surg (Torino) | year= 1991 | volume= 32 | issue= 1 | pages= 81-6 | pmid=2010458 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2010458  }} </ref> <ref name="pmid11835641">{{cite journal| author=Kini AS, Mitre CA, Kim M, Kamran M, Reich D, Sharma SK| title=A protocol for prevention of radiographic contrast nephropathy during percutaneous coronary intervention: effect of selective dopamine receptor agonist fenoldopam. | journal=Catheter Cardiovasc Interv | year= 2002 | volume= 55 | issue= 2 | pages= 169-73 | pmid=11835641 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11835641  }} </ref>
===Volume of Contrast Media===
The correlation between the amount of CM and the risk of CIN is well documented,<ref name="pmid9375704">{{cite journal| author=McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW| title=Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. | journal=Am J Med | year= 1997 | volume= 103 | issue= 5 | pages= 368-75 | pmid=9375704 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9375704  }} </ref> <ref name="pmid11835641">{{cite journal| author=Kini AS, Mitre CA, Kim M, Kamran M, Reich D, Sharma SK| title=A protocol for prevention of radiographic contrast nephropathy during percutaneous coronary intervention: effect of selective dopamine receptor agonist fenoldopam. | journal=Catheter Cardiovasc Interv | year= 2002 | volume= 55 | issue= 2 | pages= 169-73 | pmid=11835641 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11835641  }} </ref> <ref name="pmid11809444">{{cite journal| author=Diaz-Sandoval LJ, Kosowsky BD, Losordo DW| title=Acetylcysteine to prevent angiography-related renal tissue injury (the APART trial). | journal=Am J Cardiol | year= 2002 | volume= 89 | issue= 3 | pages= 356-8 | pmid=11809444 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11809444  }} </ref> <ref name="pmid8088970">{{cite journal| author=Albert SG, Shapiro MJ, Brown WW, Goodgold H, Zuckerman D, Durham R et al.| title=Analysis of radiocontrast-induced nephropathy by dual-labeled radionuclide clearance. | journal=Invest Radiol | year= 1994 | volume= 29 | issue= 6 | pages= 618-23 | pmid=8088970 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8088970  }} </ref> <ref name="pmid8657898">{{cite journal| author=Rosovsky MA, Rusinek H, Berenstein A, Basak S, Setton A, Nelson PK| title=High-dose administration of nonionic contrast media: a retrospective review. | journal=Radiology | year= 1996 | volume= 200 | issue= 1 | pages= 119-22 | pmid=8657898 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8657898  }} </ref> <ref name="pmid2389689">{{cite journal| author=Kahn JK, Rutherford BD, McConahay DR, Johnson WL, Giorgi LV, Shimshak TM et al.| title=High-dose contrast agent administration during complex coronary angioplasty. | journal=Am Heart J | year= 1990 | volume= 120 | issue= 3 | pages= 533-6 | pmid=2389689 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2389689  }} </ref>  Most of the studies indicate that the higher volume of CM have a great damaging effect in the presence of other risk factors, even relatively low doses of contrast (less than 100 ml) can induce permanent renal failure and the need for dialysis in patients with chronic kidney disease.
===Anemia and procedure-related blood loss===
Anemia might be one of the factors contributing to renal ischemia, in a study based on interventional cardiology database analysis, it showed a steadily increased rates of CIN as pre-procedure hematocrit decreased.<ref name="pmid15673320">{{cite journal| author=Nikolsky E, Mehran R, Lasic Z, Mintz GS, Lansky AJ, Na Y et al.| title=Low hematocrit predicts contrast-induced nephropathy after percutaneous coronary interventions. | journal=Kidney Int | year= 2005 | volume= 67 | issue= 2 | pages= 706-13 | pmid=15673320 | doi=10.1111/j.1523-1755.2005.67131.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15673320  }} </ref>
===Other risk factors===
Advanced [[congestive heart failure]], compromised left ventricle systolic performance, [[dehydration]], [[hypotension]], the use of several drugs ([[angiotensin-converting enzyme inhibitors]], [[diuretics]], and [[non-steroidal anti-inflammatory drugs]]) were also recognized as prognostic factors of CIN.<ref name="pmid9415932">{{cite journal| author=Pollock DM, Polakowski JS, Wegner CD, Opgenorth TJ| title=Beneficial effect of ETA receptor blockade in a rat model of radiocontrast-induced nephropathy. | journal=Ren Fail | year= 1997 | volume= 19 | issue= 6 | pages= 753-61 | pmid=9415932 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9415932  }} </ref> <ref name="pmid9017642">{{cite journal| author=Raynal-Raschilas N, Deray G, Bagnis C, Jacobs C| title=Severe acute renal failure after administration of contrast media in a patient treated with cisplatin. | journal=Nephrol Dial Transplant | year= 1996 | volume= 11 | issue= 12 | pages= 2522-3 | pmid=9017642 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9017642  }} </ref>


* [[Systolic blood pressure]] <80 mm Hg - 5 points
* Intraarterial balloon pump - 5 points
* [[Congestive heart failure]] (Class III-IV or history of pulmonary edema)  - 5 points
* Age >75 y - 4 points
* [[Hematocrit]] level <39% for men and <35% for women - 3 points
* [[Diabetes]] - 3 points
* Contrast media volume - 1 point for each 100 mL


* [[Renal insufficiency]]:
** Serum creatinine level >1.5 g/dL - 4 points ''OR''
** Estimated [[Glomerular filtration rate]] ([http://www.intmed.mcw.edu/clincalc/creatinine.html online calculator])
::* 2 for 40–60 mL/min/1.73 m2
::* 4 for 20–40 mL/min/1.73 m2
::* 6 for < 20 mL/min/1.73 m2


====Scoring:====
'''5 or less points'''
*Risk of CIN - 7.5
*Risk of Dialysis - 0.04%


'''6–10 points'''
*Risk of CIN - 14.0
*Risk of Dialysis - 0.12%


'''11–16 points'''
*Risk of CIN - 26.1*
*Risk of Dialysis - 1.09%


'''>16 points'''
*Risk of CIN -  57.3
*Risk of Dialysis -  12.8%


==References==
==References==

Revision as of 22:45, 10 September 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]

Overview

Four factors have been associated with an increased risk of contrast-induced nephropathy: pre-existing renal insufficiency, pre-existing diabetes, age, Volume of CM, and reduced intravascular volume.[1][2] A clinical prediction rule is available to estimate probability of nephropathy (increase ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 h)[3]

Risk Factors:

Pre-existing renal disease

Pre-existing renal disease with an elevated level of serum creatinine considered to be the most crucial risk factor in the development of CIN. The incidence of CIN in patients with underlying chronic kidney disease is extremely high, ranging from 14.8 to 55%[4] [1] [5] In one study, CIN occurred in one-third of 439 consecutive patients who underwent PCI despite pre-procedure hydration and the use of non-ionic CM.[5]

Although baseline creatinine is not reliable enough for identification of patients at risk for CIN, this is because serum creatinine value varies with age, muscle mass, and gender, one of the studies shown that the higher the baseline creatinine value, the greater is the risk of CIN.

If baseline plasma creatinine level is less than or equal to 1.2 mg/dl, the risk of CIN is only 2%
Values of creatinine in the range of 1.4–1.9 mg/dl, the risk of CIN compared with that in the previous group increases fivefold (10.4%)
Patients with baseline creatinine level more than 2.0 mg/dl, more than half of them (62%) subsequently develop CIN.[6]

Diabetes mellitus

Due to high prevalence of diabetes in the general population, and the ability of the disease to cause a broad spectrum of cardiovascular diseases that require radiological procedures using CM, diabetic patients represent a significant proportion of those undergoing contrast exposure with incidence of CIN varies from 5.7 to 29.4%.[7] The rates of CIN are usually comparable to those of a non-diabetic population in diabetics patients with preserved renal function.[8]

Age

The reasons for higher risk to develop CIN in elderly were not studied specifically and probably are multifactorial, including age-related changes in renal function (diminished glomerular filtration rate, tubular secretion, and concentrating ability). Several studies proved that older age is an independent predictor of CIN.[9] [10]

Volume of Contrast Media

The correlation between the amount of CM and the risk of CIN is well documented,[1] [10] [11] [12] [13] [14] Most of the studies indicate that the higher volume of CM have a great damaging effect in the presence of other risk factors, even relatively low doses of contrast (less than 100 ml) can induce permanent renal failure and the need for dialysis in patients with chronic kidney disease.

Anemia and procedure-related blood loss

Anemia might be one of the factors contributing to renal ischemia, in a study based on interventional cardiology database analysis, it showed a steadily increased rates of CIN as pre-procedure hematocrit decreased.[15]

Other risk factors

Advanced congestive heart failure, compromised left ventricle systolic performance, dehydration, hypotension, the use of several drugs (angiotensin-converting enzyme inhibitors, diuretics, and non-steroidal anti-inflammatory drugs) were also recognized as prognostic factors of CIN.[16] [17]




References

  1. ↑ 1.0 1.1 1.2 McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW (1997). "Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality". Am J Med. 103 (5): 368–75. PMID 9375704.
  2. ↑ Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr (1999). "ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions". J Am Coll Cardiol. 33 (6): 1756–824. PMID 10334456.
  3. ↑ Mehran R, Aymong ED, Nikolsky E; et al. (2004). "A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation". J. Am. Coll. Cardiol. 44 (7): 1393–9. doi:10.1016/j.jacc.2004.06.068. PMID 15464318.
  4. ↑ Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ; et al. (2002). "Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention". Circulation. 105 (19): 2259–64. PMID 12010907.
  5. ↑ 5.0 5.1 Gruberg L, Mehran R, Dangas G, Mintz GS, Waksman R, Kent KM; et al. (2001). "Acute renal failure requiring dialysis after percutaneous coronary interventions". Catheter Cardiovasc Interv. 52 (4): 409–16. doi:10.1002/ccd.1093. PMID 11285590.
  6. ↑ Hall KA, Wong RW, Hunter GC, Camazine BM, Rappaport WA, Smyth SH; et al. (1992). "Contrast-induced nephrotoxicity: the effects of vasodilator therapy". J Surg Res. 53 (4): 317–20. PMID 1405611.
  7. ↑ Nikolsky E, Mehran R, Turcot D, Aymong ED, Mintz GS, Lasic Z; et al. (2004). "Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention". Am J Cardiol. 94 (3): 300–5. doi:10.1016/j.amjcard.2004.04.023. PMID 15276092.
  8. ↑ Lasser EC, Lyon SG, Berry CC (1997). "Reports on contrast media reactions: analysis of data from reports to the U.S. Food and Drug Administration". Radiology. 203 (3): 605–10. PMID 9169676.
  9. ↑ Gussenhoven MJ, Ravensbergen J, van Bockel JH, Feuth JD, Aarts JC (1991). "Renal dysfunction after angiography; a risk factor analysis in patients with peripheral vascular disease". J Cardiovasc Surg (Torino). 32 (1): 81–6. PMID 2010458.
  10. ↑ 10.0 10.1 Kini AS, Mitre CA, Kim M, Kamran M, Reich D, Sharma SK (2002). "A protocol for prevention of radiographic contrast nephropathy during percutaneous coronary intervention: effect of selective dopamine receptor agonist fenoldopam". Catheter Cardiovasc Interv. 55 (2): 169–73. PMID 11835641.
  11. ↑ Diaz-Sandoval LJ, Kosowsky BD, Losordo DW (2002). "Acetylcysteine to prevent angiography-related renal tissue injury (the APART trial)". Am J Cardiol. 89 (3): 356–8. PMID 11809444.
  12. ↑ Albert SG, Shapiro MJ, Brown WW, Goodgold H, Zuckerman D, Durham R; et al. (1994). "Analysis of radiocontrast-induced nephropathy by dual-labeled radionuclide clearance". Invest Radiol. 29 (6): 618–23. PMID 8088970.
  13. ↑ Rosovsky MA, Rusinek H, Berenstein A, Basak S, Setton A, Nelson PK (1996). "High-dose administration of nonionic contrast media: a retrospective review". Radiology. 200 (1): 119–22. PMID 8657898.
  14. ↑ Kahn JK, Rutherford BD, McConahay DR, Johnson WL, Giorgi LV, Shimshak TM; et al. (1990). "High-dose contrast agent administration during complex coronary angioplasty". Am Heart J. 120 (3): 533–6. PMID 2389689.
  15. ↑ Nikolsky E, Mehran R, Lasic Z, Mintz GS, Lansky AJ, Na Y; et al. (2005). "Low hematocrit predicts contrast-induced nephropathy after percutaneous coronary interventions". Kidney Int. 67 (2): 706–13. doi:10.1111/j.1523-1755.2005.67131.x. PMID 15673320.
  16. ↑ Pollock DM, Polakowski JS, Wegner CD, Opgenorth TJ (1997). "Beneficial effect of ETA receptor blockade in a rat model of radiocontrast-induced nephropathy". Ren Fail. 19 (6): 753–61. PMID 9415932.
  17. ↑ Raynal-Raschilas N, Deray G, Bagnis C, Jacobs C (1996). "Severe acute renal failure after administration of contrast media in a patient treated with cisplatin". Nephrol Dial Transplant. 11 (12): 2522–3. PMID 9017642.

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