State-of-the-Art Paper
Contrast-Induced Acute Kidney Injury

https://doi.org/10.1016/j.jacc.2007.12.035Get rights and content
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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.

Abbreviations and Acronyms

AKI
acute kidney injury
CIN
contrast-induced nephropathy
CKD
chronic kidney disease
CK-MB
creatine kinase-myocardial band
Cr
creatinine
DM
diabetes mellitus
eGFR
estimated glomerular filtration rate
HOCM
high-osmolal contrast media
IOCM
iso-osmolal contrast media
LOCM
low-osmolal contrast media
MI
myocardial infarction
NAC
N-acetylcysteine
PCI
percutaneous coronary intervention

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