4.6 Article

The Pathophysiology and the Management of Radiocontrast-Induced Nephropathy

Journal

DIAGNOSTICS
Volume 12, Issue 1, Pages -

Publisher

MDPI
DOI: 10.3390/diagnostics12010180

Keywords

acute kidney injury; contrast-induced nephropathy; risk factor; pathogenesis; oxidative stress; prevention

Funding

  1. National Research Foundation of Korea (NRF) - Korea government (MSIT) [2019R1F1A1062663]
  2. National Research Foundation of Korea [2019R1F1A1062663] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)

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Contrast-induced nephropathy (CIN) is a form of kidney dysfunction that occurs after the administration of an iodinated contrast medium. Although this kidney dysfunction is typically temporary and reversible, it is the third most common cause of hospital-acquired acute kidney injury and is associated with increased morbidity and mortality. Elderly individuals, who often have multiple comorbidities, are particularly susceptible to this kidney injury, highlighting the importance of identifying its mechanisms and risk factors for optimal preventive management.
Contrast-induced nephropathy (CIN) is an impairment of renal function that occurs after the administration of an iodinated contrast medium (CM). Kidney dysfunction in CIN is considered transient and reversible in most cases. However, it is the third most common cause of hospital-acquired acute kidney injury and is associated with increased morbidity and mortality, especially in high-risk patients. Diagnostic and interventional procedures that require intravascular CM are being used with increasing frequency, especially among the elderly, who can be particularly susceptible to CIN due to multiple comorbidities. Therefore, identifying the exact mechanisms of CIN and its associated risk factors is crucial not only to provide optimal preventive management for at-risk patients, but also to increase the feasibility of diagnostic and interventional procedure that use CM. CM induces kidney injury by impairing renal hemodynamics and increasing the generation of reactive oxygen species, in addition to direct cytotoxicity. Periprocedural hydration is the most widely accepted preventive strategy to date. Here, we review the latest research results on the pathophysiology and management of CIN.

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