RT Journal Article
SR Electronic
T1 Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1461
OP 1471
DO 10.1503/cmaj.1040847
VO 172
IS 11
A1 Ilan Goldenberg
A1 Shlomi Matetzky
YR 2005
UL http://www.cmaj.ca/content/172/11/1461.abstract
AB 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.