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Contrast media-induced nephropathy: clinical burden and current attempts for prevention [Anatol J Cardiol]
Anatol J Cardiol. 2005; 5(2): 124-129

Contrast media-induced nephropathy: clinical burden and current attempts for prevention

Muhammed Habeb1, Mustafa Tarık Ağaç2, Farid Aliyev1, Seçkin Pehlivanoğlu1, Zeki Öngen3
1İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Kardiyoloji Anabilimdalı, İstanbul, Türkiye
2Clinic of Cardiology, Ahi Evren Thoracic and Vascular Surgery Training and Research Hospital, Trabzon
3Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul

Contrast media-induced nephropathy is the third most common cause of hospital acquired acute renal failure. With the increasing use of contrast media in diagnostic and interventional procedures it has become one of the major challenges encountered during routine cardiology practice. Despite clinical importance it is an under-recognized event with major morbidity and mortality. Risk of developing contrast media-induced nephropathy depends mainly on patients preexisting characteristics and physicochemical properties of the contrast agent. Primary attempts for the prevention of contrast media-induced nephropathy should include systematic review of patients characteristics and risk stratification. Patients at the greatest risk for contrast media-induced nephropathy can be defined as those having preexisting impaired renal function, diabetes mellitus, and congestive heart failure. Other risk factors include; age above seventy years, female gender, dehydration and use of high volume contrast media. The more expeditious use of iso-osmolar non-ionic contrast media reduced the incidence of contrast media related renal dysfunction. Currently, the only widely proven method of reducing the risk of contrast induced nephropathy is adequate pre and postprocedural hydration. In addition, prophylactic use of free radical scavenger N-acetylcysteine has been shown to prevent contrast media-induced nephropathy in some moderate-scale clinical trials and a meta-analysis. Despite the attempts to reduce the risk of contrast nephropathy, this clinical event affects over 25% of high risk patients and mortality remains to be high.

Keywords: Contrast media-induced nephropathy, risk stratification, prevention

Muhammed Habeb, Mustafa Tarık Ağaç, Farid Aliyev, Seçkin Pehlivanoğlu, Zeki Öngen. Contrast media-induced nephropathy: clinical burden and current attempts for prevention. Anatol J Cardiol. 2005; 5(2): 124-129

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