Contrastinduced nephropathy cin is a form of kidney damage in which there has been recent exposure to medical imaging contrast material without another. To begin position your cursor over the image above and click. Contrastinduced nephropathy is an acute deterioration of renal function after intravascular administration of contrast medium in the absence of another likely cause. I will try to get a video with my narration up in the next few days. Aug 24, 2017 the final days of contrast induced nephropathy zachary repanshek, md faaem duration. This definition is problematic because in most cases, exclusion of other. Contrastinduced nephropathy cin is a specific term used to describe a sudden deterioration in renal function that is caused by the intravascular administration of iodinated contrast medium.
Ideally, the impairment of renal function should be measured by serial creatinine clearance, but because this step may be neither practical nor costeffective in many centers, most of the. Contrastinduced nephropathy cin is the 3rd most common cause of hospitalacquired acute renal failure. Contrast associated or contrast induced nephropathy. Contrastinduced nephropathy cin is reversible acute renal failure observed after administration of iodinated contrast media cm during angiographic or other medical procedures such as urography. Contrastinduced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0. Prevention of contrast induced nephropathy cin guidelines. A novel risk score model for prediction of contrast induced nephropathy after emergent percutaneous coronary intervention. Dr t gleeson radiology discusses recent evidence regarding contrast induced nephropathy, how to prevent it and how to treat it should it happen.
Powerpoint i just export the keynote presentation to powerpoint so i suspect many of the animations are crap. Use of intravenous iodinated contrast media in patients with kidney. The incidence of contrastinduced nephropathy cin has been reported to range from 0% to 24%. It has been variably defined as an increase from baseline serum creatinine values of 2550% or as an absolute increase of 0.
Contrast induced nephropathy cin is a serious complication of angiographic procedures and results from administration of iodinated contrast media cm. Objectives were to calculate incidence of cin with routine iv contrast usage and to identify its risk factors. Lights and shadows on the pathogenesis of contrast induced nephropathy. Contrast induced nephropathy cin and its prevention is an area of emerging evidence and changing clinical. Contrastinduced nephropathy cin is defined as impairment of renal function occurring within 48 hours of administration of contrast media. To minimize the risk for contrastinduced nephropathy, various actions can be taken if. Contrastinduced nephropathy cin cannot be viewed as a treatable or acceptable complication of iodinated contrastrelated procedures, because it is associated with serious shortterm and longterm consequences. Contrast induced nephropathy cin cannot be viewed as a treatable or acceptable complication of iodinated contrast related procedures, because it is associated with serious shortterm and longterm consequences. Second, this elevation of serum creatinine should indicate genuine kidney injury rather than random fluctuations in creatinine. A widespread, rather general, definition of contrast induced nephropathy cin is an impairment in renal function occurring within 3 days following the intravascular administration of contrast media cm and the absence of an alternative aetiology.
A simple risk score for prediction of contrastinduced nephropathy after percutaneous coronary intervention. The mechanism is poorly understood in humans, with the majority of information on the pathophysiology coming from. Contrastinduced nephropathy cin is defined as the impairment of renal function and is measured as either a 25% increase in serum. To reduce the occurrence of contrast induced nephropathy, assessment and. Contrast induced nephropathy cin is common cause of hospital acquired renal failure, defined as iatrogenic deterioration of renal function following intravascular contrast administration in the absence of another nephrotoxic event.
The use of contrast media in diagnostic procedures is a potential risk for the development of acute renal failure. Use of intravenous iodinated contrast media in patients. Pathophysiology of contrast medium induced nephropathy. Risk of contrastinduced nephropathy risk of need for dialysis mehran r et al. Contrastinduced nephropathy cin is a complication of percutaneous coronary angiography that occurs in about 10 to 20% of patients exposed to contrast media. Contrastinduced nephropathy cin in the actual essence of the term refers to renal damage induced by a contrast medium. Nac reduces the occurrence of contrast induced nephropathy after nonionic contrast medium administration by half in high risk patients.
Consensus guidelines for the prevention of contrast. Contrastinduced nephropathy following angiography and. Contrast induced nephropathy cin is a form of kidney damage in which there has been recent exposure to medical imaging contrast material without another clear cause for the acute kidney injury. Pathogenesis, clinical features, and diagnosis of contrast. Hydration with ns is the most widely accepted preventive intervention. The expected increase of serum creatinine scr generally appears within 48 h after cm exposure, reaching a peak within the following 5 days. Jun 16, 2017 detrenis s, meschi m, musini s, savazzi g. Acute kidney injury, aki, cin, contrast induced nephropathy, dogmalysis, renal april 6th, 2017 leave a comment intravenous iv iodinated contrast media is used routinely to improve the accuracy of computed tomography ct in the emergency department ed. Eligible studies evaluated characteristics of predictive models that identified patients at risk of contrast induced nephropathy among adults. Feb 21, 2020 contrastinduced nephropathy cin is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine scr from baseline or 0. Prevention of contrastinduced nephropathy through a knowledge. Nacetylcysteine may be effective,but studies have given.
Yet, fear of renal failure should not dictate avoidance of diagnostic studies using iodinated contrast. May 27, 2014 contrast induced nephropathy risks and prevention. Today, i gave another talk on contrast nephropathy. Lights and shadows on the pathogenesis of contrastinduced nephropathy. Ppt contrast nephropathy powerpoint presentation free. Many authors observed patients after they received contrast cts and presumed the incidence of aki after the scan as the risk of contrast induced nephropathy. A novel risk score model for prediction of contrastinduced nephropathy after emergent percutaneous coronary intervention. Risk of contrast induced nephropathy risk of need for dialysis mehran r et al. Contrast induced acute kidney injury cardiology catheterization conference 4142011 peter danyi md the scope pubmed search contrast induced nephropathy4671 718. Contrast induced nephropathy cin is defined as impairment of renal function occurring within 48 hours of administration of contrast media. Statins use,lower incidence of cin best pharmacological strategy for prevention. Contrastinduced nephropathy cin is a serious complication of angiographic procedures and results from administration of iodinated contrast media cm.
Statins in the prevention of contrastinduced nephropathy. Contrast induced nephropathy cin emergency care institute. Iodinated contrast is used during coronary angiography to see the coronary arteries. To minimize the risk for contrast induced nephropathy, various actions can be taken if the patient has predisposing conditions. It occurs in % of nondiabetics, and in 20% of diabetics who received contrast. Contrastinduced acute kidney injury aki is one of the most common causes of hospitalacquired aki. Contrastinduced nephropathy cin is an iatrogenic acute renal failure arf. Contrastinduced nephropathy cin is a significant problem resulting from the use of iodine contrast agents in computed tomography ct scans and cath lab angiography. It has been shown that exposure to this agent may cause kidney injury.
Key points the risk of contrast induced nephropathy is directly proportional to the severity of pre existing renal insufficiency. This is an extreme presentation of a common iatrogenic problem. A number of casecontrolled studies and metaanalyzes 811 have been published, with. Contrast induced nephropathy cin describes an association between intravenous or intraarterial contrast administration and renal impairment, but increasingly the evidence shows that contrast is not the cause of the renal impairment and that confounding factors such as sepsis are likely to be responsible. Contrastinduced nephropathy cin is a frequent and severe complication in subjects receiving iodinated contrast media for diagnostic or therapeutic purposes. Contrastinduced nephropathy is defined as impairment of renal function indicated by a rise in serum creatinine by more than 25% occurring within three days of intravascular contrast administration in the absence of another aetiology. Contrastinduced nephropathy cin is a form of kidney damage in which there has been recent exposure to medical imaging contrast material without another clear cause for the acute kidney injury. Contrastinduced nephropathy cin, usually defined as an increase in serum creatinine of 44 mol litre. Contrastinduced nephropathy is most commonly defined as acute renal failure occurring within 48 hr of exposure to intravascular radiographic contrast material that is not attributable to other causes.
Columbia university medical center interventional cardiology data base. Contrastinduced nephropathy cin, also known as contrastinduced acute kidney injury ciaki is a wellknown, prevalent and serious side effect of the administration of iodine contrast medium. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast induced nephropathy amacing. First, contrast dye should cause an elevation of serum creatinine. Contrast induced nephropathy cin is a feared complication of numerous radiological procedures that expose patients to contrast media. Cin is classically defined as a serum creatinine increase of at least 25% andor an absolute increase in serum creatinine of 0. A metaanalysis6 looked at seven studies comparing hydration and acetylcysteine with hydration alone in the prevention of contrastinduced nephropathy in 805.
It has been noted that there is no consensus definition of acute renal failure and 28 different definitions have been used in the literature. The final days of contrast induced nephropathy zachary repanshek, md faaem duration. Contrast induced nephropathy cin is reversible acute renal failure observed after administration of iodinated contrast media cm during angiographic or other medical procedures such as urography. Contrastinduced nephropathy cin is an increasingly common cause of iatrogenic acute kidney injury aki associated with increased health. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrastinduced nephropathy amacing. Contrast induced nephropathy is most commonly defined as acute renal failure occurring within 48 hr of exposure to intravascular radiographic contrast material that is not attributable to other causes. Contrast induced nephropathy cin is the 3rd most common cause of hospitalacquired acute renal failure. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. To view full screen size, cursor over the player to reveal the player controls. To pause or stop the presentation, position your cursor over the video and click. Risk prediction models for contrast induced nephropathy. This wide range reported by the studies is due to differences in definition, background risk factors, type and dose of contrast medium used, and the frequency of other coexisting potential causes of acute renal failure. A simple risk score for prediction of contrast induced nephropathy after percutaneous coronary intervention. In spite of the vast clinical importance of cin, its understanding and the pathophysiology behind cin remain incomplete.
Contrast induced nephropathy cin is defined as acute renal. These studies reported frighteningly high risks of aki, with one in outpatients finding an incidence of over 10% 2. Diabetic nephropathy dehydration congestive heart failure gout age over 70. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Contrastinduced nephropathy in patients undergoing. Contrastinduced nephropathy radiology reference article.
Any internally administered substance that has a different opacity from soft tissue on radiography or computed tomography. Contrastinduced nephropathy cin is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine scr from baseline or 0. View large image view hires image download powerpoint slide. However, as noted by mcafees survey it was the advent of aortography that caused a dramatic rise in the frequency of contrast associated nephropathy 4. Combats cardiovascular disease 40% lower birck et al. Incidence of contrastinduced nephropathy a prospective study. These guidelines represent a practical approach to identification and management of patients at risk for cin.
Contrast induced nephropathy cin is the sudden deterioration of renal function resulting from intravenous iv or intraarterial ia administration of iodinated contrast media cm. Dec 03, 20 contrast induced nephropathy cin is a complication of percutaneous coronary angiography that occurs in about 10 to 20% of patients exposed to contrast media. Nonoliguric renal failure typically occurs within 2472 hours. A free powerpoint ppt presentation displayed as a flash slide show on id. Acetylcysteine to prevent acute contrastinduced nephropathy. Pathophysiology of contrast mediuminduced nephropathy.
Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Contrast induced nephropathy with intravenous iodinated. Prospective studies of patients admitted with acute renal failure arf demonstrate that intravascular contrast medium cm was responsible in 1114. No trial to date has investigated the effect of nac on hard clinical end points such as in hospital morbidity rates,mortality rates,or dialysis dependency. Prevention of contrast induced acute kidney injury ciaki. Acetylcysteine for contrastinduced nephropathy trial, published in 2011. Not only is this a leading cause of morbidity and mortality, but it also adds to increased costs in high risk patients undergoing pci. To reduce the occurrence of contrastinduced nephropathy, assessment and. Renal and cardiovascular interaction contrastinduced nephropathy contrastinduced nephropathy a form of acute kidney injury definition.
This article outlines some of the key information on the agents themselves, possible methods of action and how to prevent and treat cin. Ppt contrast induced acute kidney injury powerpoint. Third, kidney injury should result in clinically meaningful outcomes e. Contrastinduced nephropathy cin is the sudden deterioration of renal function resulting from intravenous iv or intraarterial ia administration of iodinated contrast media cm. Jul 30, 2014 key points the risk of contrast induced nephropathy is directly proportional to the severity of pre existing renal insufficiency. Of the early reports documenting acute oliguric renal failure following contrast media 2, 3 its cause was speculated to be intraluminal obstruction by precipitated bencejones protein. Sodium bicarbonate therapy for prevention of contrast induced nephropathy. Contrast induced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0. Contrast induced nephropathy cin, also known as contrast induced acute kidney injury ciaki is a wellknown, prevalent and serious side effect of the administration of iodine contrast medium.
491 1436 615 1322 1200 949 1352 379 293 1347 116 1375 806 1402 1094 1605 1130 241 1133 1164 1386 1074 1276 398 1157 700 1548 1431 328 410 1647 1232 1444 1443 737 1252 1060 230 596 797 1369 1412 1042