Contrast induced nephropathy overview: Difference between revisions
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[[Contrast media]](CM) are widely used in diagnostic and interventional procedures with rising incidence of [[iatrogenic renal function impairment]] caused by the exposure to contrast media, a condition known as Contrast-induced nephropathy(CIN). | [[Contrast media]](CM) are widely used in diagnostic and interventional procedures with rising incidence of [[iatrogenic renal function impairment]] caused by the exposure to contrast media, a condition known as Contrast-induced nephropathy(CIN). | ||
There are three necessary components for the definition of CIN | There are three necessary components for the definition of CIN <ref name="pmid16612394">{{cite journal| author=Mehran R, Nikolsky E| title=Contrast-induced nephropathy: definition, epidemiology, and patients at risk. | journal=Kidney Int Suppl | year= 2006 | volume= | issue= 100 | pages= S11-5 | pmid=16612394 | doi=10.1038/sj.ki.5000368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16612394 }} </ref> | ||
:Elevated serum creatinine compared to the baseline values | :Elevated serum creatinine compared to the baseline values | ||
:Temporal relationship between the rise in serum creatinine and exposure to a contrast agent | :Temporal relationship between the rise in serum creatinine and exposure to a contrast agent | ||
:Exclusion of alternative explanations for renal impairment | :Exclusion of alternative explanations for renal impairment | ||
Contrast-induced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0.5 mg/dL that occur 48–72 hours following the exposure to CM.<ref name="pmid16436769">{{cite journal |author=Barrett BJ, Parfrey PS |title=Clinical practice. Preventing nephropathy induced by contrast medium |journal=N. Engl. J. Med. |volume=354 |issue=4 |pages=379–86 |year=2006 |pmid=16436769 |doi=10.1056/NEJMcp050801}}</ref> According to a study that aimed to describe the course of creatinine rise and its determinants after exposure to contrast media, the first 24 hours post-exposure appear to be crucial in the development of CIN.<ref name="pmid12440177">{{cite journal| author=Guitterez NV, Diaz A, Timmis GC, O'Neill WW, Stevens MA, Sandberg KR et al.| title=Determinants of serum creatinine trajectory in acute contrast nephropathy. | journal=J Interv Cardiol | year= 2002 | volume= 15 | issue= 5 | pages= 349-54 | pmid=12440177 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12440177 }} </ref> The same study showed that patients with less than 0.5 mg/dl rise in serum creatinine within the first 24 h were unlikely to have any clinically meaningful form of CIN. | Contrast-induced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0.5 mg/dL that occur 48–72 hours following the exposure to CM.<ref name="pmid16436769">{{cite journal |author=Barrett BJ, Parfrey PS |title=Clinical practice. Preventing nephropathy induced by contrast medium |journal=N. Engl. J. Med. |volume=354 |issue=4 |pages=379–86 |year=2006 |pmid=16436769 |doi=10.1056/NEJMcp050801}}</ref> <ref name="pmid16612394">{{cite journal| author=Mehran R, Nikolsky E| title=Contrast-induced nephropathy: definition, epidemiology, and patients at risk. | journal=Kidney Int Suppl | year= 2006 | volume= | issue= 100 | pages= S11-5 | pmid=16612394 | doi=10.1038/sj.ki.5000368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16612394 }} </ref> According to a study that aimed to describe the course of creatinine rise and its determinants after exposure to contrast media, the first 24 hours post-exposure appear to be crucial in the development of CIN.<ref name="pmid12440177">{{cite journal| author=Guitterez NV, Diaz A, Timmis GC, O'Neill WW, Stevens MA, Sandberg KR et al.| title=Determinants of serum creatinine trajectory in acute contrast nephropathy. | journal=J Interv Cardiol | year= 2002 | volume= 15 | issue= 5 | pages= 349-54 | pmid=12440177 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12440177 }} </ref> <ref name="pmid16612394">{{cite journal| author=Mehran R, Nikolsky E| title=Contrast-induced nephropathy: definition, epidemiology, and patients at risk. | journal=Kidney Int Suppl | year= 2006 | volume= | issue= 100 | pages= S11-5 | pmid=16612394 | doi=10.1038/sj.ki.5000368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16612394 }} </ref> The same study showed that patients with less than 0.5 mg/dl rise in serum creatinine within the first 24 h were unlikely to have any clinically meaningful form of CIN. | ||
Revision as of 18:52, 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
Contrast media(CM) are widely used in diagnostic and interventional procedures with rising incidence of iatrogenic renal function impairment caused by the exposure to contrast media, a condition known as Contrast-induced nephropathy(CIN).
There are three necessary components for the definition of CIN [1]
- Elevated serum creatinine compared to the baseline values
- Temporal relationship between the rise in serum creatinine and exposure to a contrast agent
- Exclusion of alternative explanations for renal impairment
Contrast-induced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0.5 mg/dL that occur 48–72 hours following the exposure to CM.[2] [1] According to a study that aimed to describe the course of creatinine rise and its determinants after exposure to contrast media, the first 24 hours post-exposure appear to be crucial in the development of CIN.[3] [1] The same study showed that patients with less than 0.5 mg/dl rise in serum creatinine within the first 24 h were unlikely to have any clinically meaningful form of CIN.
References
- ↑ 1.0 1.1 1.2 Mehran R, Nikolsky E (2006). "Contrast-induced nephropathy: definition, epidemiology, and patients at risk". Kidney Int Suppl (100): S11–5. doi:10.1038/sj.ki.5000368. PMID 16612394.
- ↑ Barrett BJ, Parfrey PS (2006). "Clinical practice. Preventing nephropathy induced by contrast medium". N. Engl. J. Med. 354 (4): 379–86. doi:10.1056/NEJMcp050801. PMID 16436769.
- ↑ Guitterez NV, Diaz A, Timmis GC, O'Neill WW, Stevens MA, Sandberg KR; et al. (2002). "Determinants of serum creatinine trajectory in acute contrast nephropathy". J Interv Cardiol. 15 (5): 349–54. PMID 12440177.