Contrast-induced nephropathy; A literature review.
Contrast-induced nephropathy; A literature review.
复制标题
DOI：
10.12860/jnp.2014.12
复制
发表时间：
2014-01-01
影响因子：
--
通讯作者：
Gharipour, Mojgan
中科院分区：
文献类型：
--
作者：
Golshahi, Jafar;Nasri, Hamid;Gharipour, Mojgan
背景：造影剂肾病（CIN）是急性肾功能不全的常见原因，证据获取：已检索开放存取期刊目录、Google Scholar、PubMed、EBSCO和Web of Science。结果：有必要在早期识别高危患者，实施预防策略，以降低这种肾病的发生率。然而，CIN的发病机制尚未完全阐明。一氧化氮介导的血管舒张作用和洋地黄素介导的血管舒张作用在CIN的发生发展中起着重要作用。肾血流的血流动力学改变，导致肾髓质缺氧和造影剂对肾细胞的直接毒性作用，被认为有助于CIN的发病机制。造影剂通常分为等渗、低渗和高渗。结论：识别高危人群，控制相关危险因素是预防CIN的首要目标。由于造影剂的理化性质存在显著差异，因此应使用低渗或等渗造影剂预防高危患者的CIN。造影剂的体积应尽可能低。
CONTEXT: Contrast-induced nephropathy (CIN) is a common cause of acute kidney dysfunction.EVIDENCE ACQUISITIONS: Directory of Open Access Journals, Google Scholar, PubMed, EBSCO and Web of Science have been searched.RESULTS: It is necessary to identify at risk patients at early stages to implement preventive strategies to decrease the incidence of this nephropathy. However, mechanisms of CIN have not fully explained yet. It seems that mechanisms which mediated by nitric oxide and prostaglandin-induced vasodilatation have been played a crucial role in the CIN. Hemodynamic changes of renal blood flow, which causes hypoxia in the renal medulla and direct toxic effects of contrast media on renal cells, are thought to contribute to the pathogenesis of CIN. Contrast media is normally divided into iso-osmolar, low-osmolar, and high-osmolar. N-acetylcysteine is considered as one of the best choices to prevent CIN in high-risk groups.CONCLUSIONS: The first aim to prevent CIN is identifying high-risk subjects and controlling associate risk factors. As significant differences existed between contrasts agents due to their physicochemical properties, low-osmolar or iso-osmolar contrast media should be used to prevent CIN in at-risk patients. The volume of contrast media should be as low as possible.