Encefalopatía inducida por contraste en pacientes con enfermedad renal crónica avanzada: aquello que el nefrólogo necesita saber

IF 2 4区 医学 Q2 UROLOGY & NEPHROLOGY Nefrologia Pub Date : 2024-05-01 DOI:10.1016/j.nefro.2023.05.007
Víctor Joaquín Escudero-Saiz , Nathalie Melissa Romani , Pastora Rodríguez , Laura Morantes , Jimena Del Risco-Zevallos , Joaquim Casals , Marc Xipell , Elena Guillén , Gastón J. Piñeiro , Miguel Blasco , Lida M. Rodas , Luis F. Quintana , Esteban Poch , Daniel Santana , Alicia Molina Andújar
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Abstract

Contrast-induced encephalopathy is a neurological complication related to contrast used in endovascular procedures or computed tomography (CT). The main risk factors are arterial hypertension, diabetes mellitus, chronic kidney disease (CKD), hyperosmolar contrasts, the amount of infused contrast and its direct infusion in the posterior cerebral territory, or pathologies with blood–brain barrier damage. Symptomatology is non-specific and may present as altered level of consciousness, neurological focality or seizures. Diagnosis is done by exclusion after ischemic or hemorrhagic stroke has been ruled out; CT or MRI are useful for differentiation. Generally, it appears shortly after exposure and the symptoms lasts 48–72 h with complete recovery, although cases with persistence of symptoms or longer duration have been described. Treatment consists of monitoring, supportive measures and renal replacement therapy (RRT) with hemodialysis (HD) in patients in chronic RRT program. It is important for the nephrologist to be aware of this entity given the susceptibility of the patient on HD as well as its potential therapeutic role in these patients.

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晚期慢性肾脏疾病患者的造影剂诱发脑病:肾脏科医生需要知道的
造影剂诱发脑病是一种与血管内手术或计算机断层扫描(CT)中使用的造影剂有关的神经系统并发症。主要的危险因素包括动脉高血压、糖尿病、慢性肾脏病(CKD)、高渗造影剂、输注造影剂的量和直接输注到大脑后区,或血脑屏障损伤的病变。症状无特异性,可能表现为意识水平改变、神经系统病灶或癫痫发作。在排除缺血性或出血性中风后,通过排除法进行诊断;CT 或 MRI 有助于鉴别。一般在接触后不久出现,症状持续 48-72 小时后完全恢复,但也有症状持续或持续时间更长的病例。治疗包括监测、支持性措施和肾脏替代疗法(RRT),慢性 RRT 患者可进行血液透析(HD)。鉴于血液透析患者的易感性以及血液透析对这些患者的潜在治疗作用,肾科医生必须了解这种疾病。
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来源期刊
Nefrologia
Nefrologia 医学-泌尿学与肾脏学
CiteScore
3.40
自引率
7.70%
发文量
148
审稿时长
47 days
期刊介绍: Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.
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