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==Natural history, Complications and Prognosis==
==Natural history, Complications and Prognosis==
There is a complicated relationship between CIN, comorbidity, and mortality. Most patients who develop CIN do not die from renal failure rather than from either a preexisting nonrenal complication, or a procedural complication.
Studies have substantiated greater all-cause and cardiovascular mortality<ref name="pmid15519007">{{cite journal| author=Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I et al.| title=Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. | journal=J Am Coll Cardiol | year= 2004 | volume= 44 | issue= 9 | pages= 1780-5 | pmid=15519007 | doi=10.1016/j.jacc.2004.07.043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15519007  }} </ref>, prolonged duration of hospitalization<ref name="pmid14668704">{{cite journal| author=McCullough PA, Sandberg KR| title=Epidemiology of contrast-induced nephropathy. | journal=Rev Cardiovasc Med | year= 2003 | volume= 4 Suppl 5 | issue=  | pages= S3-9 | pmid=14668704 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14668704  }} </ref>, and late cardiovascular events<ref name="pmid16949375">{{cite journal| author=McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F et al.| title=Epidemiology and prognostic implications of contrast-induced nephropathy. | journal=Am J Cardiol | year= 2006 | volume= 98 | issue= 6A | pages= 5K-13K | pmid=16949375 | doi=10.1016/j.amjcard.2006.01.019 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16949375  }} </ref> associated with CIN. The evidence is seen mostly in patients undergoing PCI.
 
Nonrenal complications include procedural cardiac complications (eg, Q-wave MI, [[coronary artery bypass graft]] [CABG], [[hypotension]], [[shock]]), vascular complications (eg, femoral bleeding, [[hematoma]], [[pseudoaneurysm]], [[stroke]]), and systemic complications (eg, [[acute respiratory distress syndrome]] [ARDS], [[pulmonary embolism]]).


==References==
==References==

Revision as of 21:17, 1 October 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

The reported incidence varies widely according to the presence or absence of risk factors, and usually associated with a significantly higher risk of in-hospital and 1-year mortality, even in patients who do not need dialysis.

Natural history, Complications and Prognosis

Studies have substantiated greater all-cause and cardiovascular mortality[1], prolonged duration of hospitalization[2], and late cardiovascular events[3] associated with CIN. The evidence is seen mostly in patients undergoing PCI.

References

  1. Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I; et al. (2004). "Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction". J Am Coll Cardiol. 44 (9): 1780–5. doi:10.1016/j.jacc.2004.07.043. PMID 15519007.
  2. McCullough PA, Sandberg KR (2003). "Epidemiology of contrast-induced nephropathy". Rev Cardiovasc Med. 4 Suppl 5: S3–9. PMID 14668704.
  3. McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F; et al. (2006). "Epidemiology and prognostic implications of contrast-induced nephropathy". Am J Cardiol. 98 (6A): 5K–13K. doi:10.1016/j.amjcard.2006.01.019. PMID 16949375.

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