Contrast-induced nephropathy: Pharmacological prophylaxis
Contrast-induced nephropathy: Pharmacological prophylaxis
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DOI：
10.1038/sj.ki.5000372
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发表时间：
2006-04-01
影响因子：
19.6
通讯作者：
Marenzi, G
中科院分区：
文献类型：
--
作者：
Briguori, C;Marenzi, G
造影剂相关性急性肾功能衰竭是院内肾功能恶化的第三大常见原因，仅次于肾血流灌注减少和术后肾功能不全。虽然一般情况下是良性的，但这种并发症与死亡率有关，死亡率从3.8%到%不等，这取决于肌酐浓度的增加。已经对多种药物进行了测试，试图防止这种并发症。造影剂所致肾毒性(CIN)的病理生理学核心是肾脏血流动力学的改变。为了逆转这些血流动力学变化，血管洗涤剂和利尿剂已被测试为预防药物。然而，它们的有效性尚未得到证实。最近，关于预防性使用抗氧化剂化合物，如乙酰半胱氨酸和抗坏血酸的有效性的初步积极数据引起了相当大的兴趣。在这篇综述中，我们重点介绍预防CIN的药物治疗的有效性。
Contrast media-associated acute renal failure represents the third most common cause of in-hospital renal function deterioration after decreased renal perfusion and post-operative renal insufficiency. Although generally benign, this complication is associated with a mortality rate ranging from 3.8 to 64%, depending on the increase of creatinine concentration. Multiple drugs have been tested in an attempt to prevent this complication. Central to the pathophysiology of contrast-induced nephrotoxicity (CIN) is an alteration in renal hemodynamics. In an effort to reverse these hemodynamic changes, vasoclilators and diuretics have been tested as prophylactic drugs. However, their effectiveness has not been confirmed. Recently, considerable interest has resulted from the initial positive data on the effectivess of prophylactic administration of antioxidant compounds, such as acetylcysteine and ascorbic acid. In this review, we focus on the effectiveness of pharmacologic therapies for preventing CIN.