Contrast‐induced Kidney Injury: Focus on Modifiable Risk Factors and Prophylactic Strategies

摘要

Contrast‐induced nephropathy, also known as contrast‐induced acute kidney injury, is associated with rapid and often irreversible decline in kidney function following the administration of iodinated contrast agents. Contrast‐induced nephropathy is the third leading cause of acute kidney injury in hospitalized patients, and substantially increases mortality, morbidity, and length of hospitalization. Contrast‐induced nephropathy follows a predictable time of onset and is potentially preventable. It has been the subject of numerous studies addressing characteristics of the populations at risk and prophylactic strategies. This evidence‐based review summarizes recent literature and provides a nephrologists' perspective on contrast‐induced nephropathy, focusing on: the pathophysiology of contrast‐induced nephropathy; identification of populations at risk; correlation between contrast‐induced nephropathy and the type of contrast agent used; and finally, measures to prevent contrast‐induced nephropathy, including intravenous fluids, sodium bicarbonate, N‐acetylcysteine, and hemofiltration/hemodialysis. Copyright © 2010 Wiley Periodicals, Inc.