Evidence-based management of patients undergoing PCI: contrast-induced acute kidney injury

Catheter Cardiovasc Interv. 2010 Mar 1:75 Suppl 1:S15-20. doi: 10.1002/ccd.22376.

Abstract

Contrast-induced acute kidney injury (CI-AKI) is one of the leading causes of hospital-acquired acute kidney injury. CI-AKI is highly prevalent in patients with well-known risk factors, including older age, chronic renal insufficiency, congestive heart failure, and diabetes. Thus far, no strategies have been shown to be effective in preventing CI-AKI beyond thorough patient selection, minimizing the amount of contrast agent, and meticulous hydration of the patient. The role of various drugs in preventing CI-AKI is still controversial and warrants future studies. Despite the remaining uncertainty regarding the degree of nephrotoxicity produced by various contrast agents, nonionic low-osmolar contrast media may be preferred in patients at high risk for CI-AKI.

Publication types

  • Review

MeSH terms

  • Acetylcysteine / administration & dosage
  • Acute Disease
  • Angioplasty, Balloon, Coronary*
  • Contrast Media / adverse effects*
  • Dopamine / administration & dosage
  • Drug Administration Routes
  • Evidence-Based Medicine
  • Fenoldopam / administration & dosage
  • Fluid Therapy
  • Humans
  • Kidney Diseases / chemically induced
  • Kidney Diseases / prevention & control*
  • Patient Selection
  • Practice Guidelines as Topic
  • Protective Agents / administration & dosage
  • Radiography, Interventional / adverse effects*
  • Risk Assessment
  • Risk Factors
  • Sodium Bicarbonate / administration & dosage
  • Treatment Outcome

Substances

  • Contrast Media
  • Protective Agents
  • Sodium Bicarbonate
  • Fenoldopam
  • Dopamine
  • Acetylcysteine