Advertisement
ADVANCED SEARCH

This Article Figures Only Full Text Full Text (PDF) Correction (v173,p1210) Submit a response View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Goldenberg, I. Articles by Matetzky, S. Search for Related Content PubMed PubMed Citation Articles by Goldenberg, I. Articles by Matetzky, S. Related Collections Radiological diagnosis Nephrology

Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies

From the Heart Institute, Sheba Medical Center, Tel Hashomer, Israel (both authors)

Correspondence to: Dr. Ilan Goldenberg, Heart Institute, Sheba Medical Center, Tel Hashomer 52621, Israel; fax +972 3 534 3888; ilan.goldenberg{at}heart.rochester.edu or vivienne.york{at}sheba.health.gov.il

Abstract

WITH THE INCREASING USE OF CONTRAST MEDIA in diagnostic and interventional procedures, nephropathy induced by contrast media has become the third leading cause of hospital-acquired acute renal failure. It is also associated with a significant risk of morbidity and death. The current understanding of the pathogenesis indicates that contrast-medium nephropathy is caused by a combination of renal ischemia and direct toxic effects on renal tubular cells. Patients with pre-existing renal insufficiency, diabetes mellitus and congestive heart failure are at highest risk. Risk factors also include the type and amount of contrast medium administered. Therapeutic prevention strategies are being extensively investigated, but there is still no definitive answer. In this article, we review the current evidence on the causes, pathogenesis and clinical course of contrast-medium nephropathy as well as therapeutic approaches to its prevention evaluated in clinical trials.

This article has been cited by other articles:

				D. Kiski, W. Stepper, E. Brand, G. Breithardt, and H. Reinecke Impact of renin-angiotensin-aldosterone blockade by angiotensin-converting enzyme inhibitors or AT-1 blockers on frequency of contrast medium-induced nephropathy: a post-hoc analysis from the Dialysis-versus-Diuresis (DVD) trial Nephrol. Dial. Transplant., November 9, 2009; (2009) gfp582v1. [Abstract] [Full Text] [PDF]

				A. THENGAMPALLIL and S. S THENGAMPALLIL Pharmacology in Radiology Radiol. Technol., July 1, 2009; 80(6): 547 - 563. [Abstract] [Full Text] [PDF]

				R. Mehran, E. Nikolsky, A. J. Kirtane, A. Caixeta, S. C. Wong, P. S. Teirstein, W. E. Downey, W. B. Batchelor, P. J. Casterella, Y.-H. Kim, et al. Ionic Low-Osmolar Versus Nonionic Iso-Osmolar Contrast Media to Obviate Worsening Nephropathy After Angioplasty in Chronic Renal Failure Patients: The ICON (Ionic versus non-ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) Study J. Am. Coll. Cardiol. Intv., May 1, 2009; 2(5): 415 - 421. [Abstract] [Full Text] [PDF]

				J.J. Hopyan, D.J. Gladstone, G. Mallia, J. Schiff, A.J. Fox, S.P. Symons, B.H. Buck, S.E. Black, and R.I. Aviv Renal Safety of CT Angiography and Perfusion Imaging in the Emergency Evaluation of Acute Stroke AJNR Am. J. Neuroradiol., November 1, 2008; 29(10): 1826 - 1830. [Abstract] [Full Text] [PDF]

				L. M. Boxt CT angiography in children: it is accurate, but is it safe? J. Am. Coll. Cardiol. Img., May 1, 2008; 1(3): 340 - 342. [Full Text] [PDF]

				Y. Yokomaku, T. Sugimoto, S. Kume, S.-i. Araki, K. Isshiki, M. Chin-Kanasaki, M. Sakaguchi, N. Nitta, M. Haneda, D. Koya, et al. Asialoerythropoietin Prevents Contrast-Induced Nephropathy J. Am. Soc. Nephrol., February 1, 2008; 19(2): 321 - 328. [Abstract] [Full Text] [PDF]

				G. T. C. Wong and M. G. Irwin Contrast-induced nephropathy Br. J. Anaesth., October 1, 2007; 99(4): 474 - 483. [Abstract] [Full Text] [PDF]

				K. W. Park, B.-K. Koo, H.-L. Kim, Y.-S. Kim, S.-H. Jo, H.-Y. Lee, H.-J. Kang, Y.-S. Cho, W.-Y. Chung, T.-J. Yeon, et al. The incidence and predictors of contrast-induced nephropathy in adequately hydrated elderly patients with impaired renal function Nephrol. Dial. Transplant., June 1, 2007; 22(6): 1794 - 1795. [Full Text] [PDF]

				A. Recio-Mayoral, M. Chaparro, B. Prado, R. Cozar, I. Mendez, D. Banerjee, J. C. Kaski, J. Cubero, and J. M. Cruz The Reno-Protective Effect of Hydration With Sodium Bicarbonate Plus N-Acetylcysteine in Patients Undergoing Emergency Percutaneous Coronary Intervention: The RENO Study J. Am. Coll. Cardiol., March 27, 2007; 49(12): 1283 - 1288. [Abstract] [Full Text] [PDF]

				P. Schmidt, D. Pang, D. Nykamp, G. Knowlton, and H. Jia N-Acetylcysteine and Sodium Bicarbonate Versus N-Acetylcysteine and Standard Hydration for the Prevention of Radiocontrast-Induced Nephropathy Following Coronary Angiography Ann. Pharmacother., January 1, 2007; 41(1): 46 - 50. [Abstract] [Full Text] [PDF]

				T. Schachner, J. Bonatti, N. Bonaros, R. Poeltl, G. Feuchtner, G. Laufer, O. Pachinger, and G. Friedrich Risk factors of postoperative nephropathy in patients undergoing innovative CABG and intraoperative graft angiography. Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 431 - 435. [Abstract] [Full Text] [PDF]

				M. Tepel, P. Aspelin, and N. Lameire Contrast-Induced Nephropathy: A Clinical and Evidence-Based Approach Circulation, April 11, 2006; 113(14): 1799 - 1806. [Full Text] [PDF]

eLetters:

HOME	CURRENT ISSUE	PAST ISSUES	COLLECTIONS	HELP	SEARCH
Copyright 1995-2005, Canadian Medical Association. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p) All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.