Prevention of radiocontrast-induced nephropathy

被引:100
作者
Asif, A [1 ]
Epstein, M [1 ]
机构
[1] Univ Miami, Sch Med, Dept Med, Div Nephrol, Miami, FL 33136 USA
关键词
radiocontrast-induced nephropathy; fenoldopam; N-acetylcysteine (NAC); ultrafiltration; iso-osmolar agents;
D O I
10.1053/j.ajkd.2004.04.001
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Radiocontrast administration is a common cause of hospital-acquired acute renal failure. It is associated with significant in-hospital and long-term morbidity and mortality and increases the costs of medical care by at least extending the hospital stay. Although individuals with normal renal function generally are not considered to be at particular risk, patients with preexisting renal failure are much more likely to experience this complication after radiocontrast agent administration. Typically, serum creatinine levels begin to increase at 48 to 72 hours, peak at 3 to 5 days, and return to baseline within another 3 to 5 days. A variety of therapeutic interventions, including saline hydration, diuretics, mannitol, calcium channel antagonists, theophylline, endothelin receptor antagonists, and dopamine, have been used in an attempt to prevent radiocontrast-induced nephropathy. Of these, saline hydration is the sole efficacious therapy to protect against radiocontrast-induced nephropathy. Recent advances have examined the impact of fenoldopam (dopamine-1 [DA-1] receptor; DA-1 agonist), the antioxidant N-acetylcysteine, iso-osmolar contrast agents, hemodialysis, and hemofiltration in ameliorating radiocontrast-induced nephropathy. This review focuses on current interventions to ameliorate radiocontrast-induced acute renal failure and provides an analysis of some of the recent studies conducted to halt radiocontrast-induced nephropathy.
引用
收藏
页码:12 / 24
页数:13
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