Intravenous Contrast Medium-induced Nephrotoxicity: Is the Medical Risk Really as Great as We Have Come to Believe?

被引:182
作者
Katzberg, Richard W. [1 ]
Newhouse, Jeffrey H. [2 ]
机构
[1] Univ Calif, Davis Med Ctr, Dept Radiol, Sacramento, CA 95817 USA
[2] Columbia Univ, Dept Radiol, Med Ctr, New York, NY USA
关键词
ACUTE-RENAL-FAILURE; ELEVATED SERUM CREATININE; CHRONIC KIDNEY-DISEASE; INDUCED NEPHROPATHY; COMPUTED-TOMOGRAPHY; DIABETIC-PATIENTS; TRAUMA PATIENTS; ANGIOGRAPHY; CT; CLEARANCE;
D O I
10.1148/radiol.10092000
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
From the multiple perspectives described, it is our belief that the risk of CIN with CE CT has been exaggerated. Clinical rates and adverse outcomes from cardiac catheterization and intervention cannot be extrapolated to the clinical experience with CE CT. It appears that all currently used nonionic CM have similar safety profiles. We believe that modern CM pose only a small risk to renal function and that thresholds of creatinine above which CM are withheld for CT should be increased to improve the accuracy of CT examinations. The population of patients with mild to moderate renal dysfunction who would then receive CM should be analyzed carefully to determine whether the thresholds subsequently can be increased further. International radiologic professional organizations, such as the American College of Radiology, should revisit the basis of their practice guidelines to reduce their implications about the danger of CIN with CE CT. © RSNA, 2010.
引用
收藏
页码:21 / 28
页数:8
相关论文
共 44 条
[1]   Reproducibility of renal function measurements in adult men with diabetic nephropathy: Research and clinical implications [J].
Agarwal, Rajiv .
AMERICAN JOURNAL OF NEPHROLOGY, 2007, 27 (01) :92-100
[2]   ANALYSIS OF RADIOCONTRAST-INDUCED NEPHROPATHY BY DUAL-LABELED RADIONUCLIDE CLEARANCE [J].
ALBERT, SG ;
SHAPIRO, MJ ;
BROWN, WW ;
GOODGOLD, H ;
ZUCKERMAN, D ;
DURHAM, R ;
KERN, M ;
FLETCHER, J ;
WOLVERSON, M ;
PLUMMER, ES ;
BAUE, AE .
INVESTIGATIVE RADIOLOGY, 1994, 29 (06) :618-623
[3]   NON-OLIGURIC ACUTE RENAL-FAILURE [J].
ANDERSON, RJ ;
LINAS, SL ;
BERNS, AS ;
HENRICH, WL ;
MILLER, TR ;
GABOW, PA ;
SCHRIER, RW .
NEW ENGLAND JOURNAL OF MEDICINE, 1977, 296 (20) :1134-1138
[4]   Measurement of Change in Estimated Glomerular Filtration Rate in Patients With Renal Insufficiency After Contrast-Enhanced Computed Tomography: A Case-Control Study [J].
Bansal, Gaurav Jyoti ;
Darby, Michael .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 2009, 33 (03) :455-459
[5]   Contrast-induced nephropathy in patients with chronic kidney disease undergoing computed tomography - A double-blind comparison of iodixanol and iopamidol [J].
Barrett, Brendan J. ;
Katzberg, Richard W. ;
Thomsen, Henrik S. ;
Chen, Nan ;
Sahani, Dushyant ;
Soulez, Gilles ;
Heiken, Jay P. ;
Lepanto, Luigi ;
Ni, Zhou-Hui ;
Nelson, Rendon .
INVESTIGATIVE RADIOLOGY, 2006, 41 (11) :815-821
[6]   Use of iso-osmolar nonionic dimeric contrast media in multidetector row computed tomography angiography for patients with renal impairment [J].
Becker, CR ;
Reiser, MF .
INVESTIGATIVE RADIOLOGY, 2005, 40 (10) :672-675
[7]   Background Fluctuation of Kidney Function Versus Contrast-Induced Nephrotoxicity [J].
Bruce, Richard J. ;
Djamali, Aji ;
Shinki, Kazuhiko ;
Michel, Steven J. ;
Fine, Jason P. ;
Pozniak, Myron A. .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2009, 192 (03) :711-718
[8]   RADIOCONTRAST-INDUCED ACUTE RENAL-FAILURE - CLINICAL AND PATHOPHYSIOLOGIC REVIEW [J].
BYRD, L ;
SHERMAN, RL .
MEDICINE, 1979, 58 (03) :270-279
[9]  
CAMPBELL DR, 1990, J CAN ASSOC RADIOL, V41, P133
[10]  
Carrick M, 2005, J TRAUMA, V59, P1166