Contrast-induced acute kidney injury
Contrast-induced acute kidney injury
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DOI：
10.1016/j.jacc.2007.12.035
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发表时间：
2008-04-15
影响因子：
24
通讯作者：
McCullough, Peter A.
中科院分区：
文献类型：
--
作者：
McCullough, Peter A.
心脏血管造影术和冠状动脉/血管介入术依赖于碘化造影剂，因此存在造影剂诱导的急性肾损伤（阿基）风险。这是一种重要的并发症，导致大量的医院获得性肾衰竭病例，对预后和医疗保健费用产生不利影响。本报告讨论了造影剂诱导阿基的流行病学和发病机制、基线肾功能测量、风险评估、高风险患者的识别、造影剂使用和预防策略。建议采用一种先进的算法对造影剂诱导的阿基进行风险分层和管理，因为它与接受心血管手术的患者有关。造影剂诱导的阿基可能在未来仍然是心脏病专家面临的重大挑战，因为患者人群正在老龄化，慢性肾脏疾病和糖尿病变得越来越常见。
Cardiac angiography and coronary/vascular interventions depend on iodinated contrast media and consequently pose the risk of contrast-induced acute kidney injury (AKI). This is an important complication that accounts for a significant number of cases of hospital-acquired renal failure, with adverse effects on prognosis and health care costs. The epidemiology and pathogenesis of contrast-induced AKI, baseline renal function measurement, risk assessment, identification of high-risk patients, contrast medium use, and preventive strategies are discussed in this report. An advanced algorithm is suggested for the risk stratification and management of contrast-induced AKI as it relates to patients undergoing cardiovascular procedures. Contrast-induced AKI is likely to remain a significant challenge for cardiologists in the future because the patient population is aging and chronic kidney disease and diabetes are becoming more common.