La prevenzione dell'insufficienza renale acuta da mezzo di contrasto

Translated title of the contribution: Prevention of contrast-induced acute kidney injury

Carlo Guastoni, Stefano De Servi, Patrizia Covella, Corrado Turri, Barbaro Gidaro, Nicoletta Bellotti, Antonia Stasi

Research output: Contribution to journalArticle

Abstract

Contrast-induced nephropathy (CIN) is one of the most frequent causes of acute kidney injury in hospitalized patients. Its incidence depends on patient risk factors (chronic kidney disease, diabetes, cardiovascular diseases and older age) and procedure-related factors (high contrast dose, intraarterial administration). Chronic kidney disease, especially if associated with diabetes, is the main risk factor for CIN. Hydration before and after contrast administration is the only preventive therapy that is strongly recommended by guidelines in patients at risk. CIN prevention studies have focused mainly on cardiac patients with a moderate renal risk (GFR 60-40 mL/min) who underwent intraarterial contrast administration. Many clinical trials have evaluated the efficacy of hydration associated with sodium bicarbonate and of N-acetylcysteine (NAC) in CIN prevention. Sodium bicarbonate infusion has shown better efficacy than saline infusion, particularly when short infusion times are needed, such as in emergency procedures. NAC has not shown any clear effect, and some positive study results have not been confirmed in other trials. The discussion is still open on the efficacy of renal replacement therapies for the prevention of CIN in individuals at high renal risk (GFR

Translated title of the contributionPrevention of contrast-induced acute kidney injury
Original languageItalian
Pages (from-to)S33-S45
JournalGiornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Volume29
Publication statusPublished - Nov 1 2012

ASJC Scopus subject areas

  • Medicine(all)

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