Open AccessPreventing radiocontrast-induced nephropathy in chronic kidney disease patients undergoing coronary angiography
Author(s) -
Yao-Min Hung,
Shoa-Lin Lin,
Shih-Yuan Hung,
Wei-Chun Huang,
Paul Yung-Pou Wang
Publication year - 2012
Publication title -
world journal of cardiology
Language(s) - English
Resource type - Journals
ISSN - 1949-8462
DOI - 10.4330/wjc.v4.i5.157
Subject(s) - medicine , kidney disease , acute kidney injury , nephropathy , adverse effect , angiography , cardiology , renal replacement therapy , creatinine , complication , coronary angiography , myocardial infarction , intensive care medicine , diabetes mellitus , endocrinology
Radiocontrast-induced nephropathy (RCIN) is an acute and severe complication after coronary angiography, particularly for patients with pre-existing chronic kidney disease (CKD). It has been associated with both short- and long-term adverse outcomes, including the need for renal replacement therapy, increased length of hospital stay, major cardiac adverse events, and mortality. RCIN is generally defined as an increase in serum creatinine concentration of 0.5 mg/dL or 25% above baseline within 48 h after contrast administration. There is no effective therapy once injury has occurred, therefore, prevention is the cornerstone for all patients at risk for acute kidney injury (AKI). There is a small but growing body of evidence that prevention of AKI is associated with a reduction in later adverse outcomes. The optimal strategy for preventing RCIN has not yet been established. This review discusses the principal risk factors for RCIN, evaluates and summarizes the evidence for RCIN prophylaxis, and proposes recommendations for preventing RCIN in CKD patients undergoing coronary angiography.