[造影剂毒性及其预防]。

Concetto Sessa, Luca Zanoli, Giovanni Noto, Ivana Alessandrello, Dario Galeano, Elisa Giglio, Alfio Edoardo Giuffrida, Giulio Distefano, Vincenzo Ficara, Roberta Maria Messina, Stella Musumeci, Viviana Scollo, Fortunata Zirino, Carmelo Zuppardo, Walter Morale
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引用次数: 0

摘要

静脉注射碘造影剂在临床实践中广泛使用,从医学成像到介入放射学(IR)程序和血管内介入。与肾功能正常的患者相比,肾病患者发生急性肾损伤(AKI)的风险增高。然而,这种情况不能代表诊断或血管内干预的限制。尽管过去五年有文献报道,但对肾病患者的管理和治疗方法仍然存在冲突,包括使用造影剂和替代肾功能的治疗,这些通常被错误地认为是预防策略的一部分。虽然这个问题已经被广泛讨论,但专家们经常在处理造影剂管理和肾脏咨询请求方面遇到不确定性。此外,一般难以区分造影剂后急性肾损伤(PC-AKI)和造影剂相关急性肾损伤(CI-AKI)。本综述旨在提供这一问题的最新进展,并探讨降低造影剂使用后急性肾损伤风险的策略。这些策略包括早期识别高危个体,选择造影剂和合适剂量,停用肾毒性药物,对高危个体进行随访,早期识别AKI。
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[Contrast Media Toxicity and Its Prevention].

Intravenous iodinated contrast media are commonly used in clinical practice, ranging from medical imaging to interventional radiology (IR) procedures and endovascular interventions. Compared with patients with normal renal function, nephropathic patients have an increased risk of acute kidney injury (AKI). Nevertheless, this condition cannot represent a limit to diagnostics or endovascular interventions. Despite the literature of the last five years, conflicting management and approaches for nephropathic patients persist, including the use of contrast agents and treatments replacing renal functions, which are often mistakenly considered as part of preventive strategies. Though the issue has been widely discussed, specialists often cope with uncertainty in handling properly the administration of contrast media and renal counselling requests. Furthermore, there is a general difficulty in distinguishing the Post-Contrast Acute Kidney Injury (PC-AKI) from the Contrast-Associated Acute Kidney Injury (CI-AKI). The present review aims to provide an update on the issue and examine strategies to reduce the acute kidney injury risk after the administration of contrast media. These strategies include the early identification of high-risk individuals, the choice of the contrast media and the proper dosage, the suspension of nephrotoxic drugs, the follow-up of the high-risk individuals, and the early identification of AKI.

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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
62
期刊介绍: Il Giornale Italiano di Nefrologia (GIN) è la rivista di educazione continua della Società Italiana di Nefrologia SIN ed è pubblicato bimestralmente. E" il più autorevole organo di informazione nefrologia disponibile a livello nazionale. Il giornale Italiano di Nefrologia offre la più aggiornata informazione medico-scientifica rivolta al nefrologo sotto forma di rassegne, casi clinici e articoli finalizzati all’Educazione Continua in Medicina, oltre ai notiziari ed agli atti dei congressi di questa prestigiosa Società Scientifica
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