Abstract
Contrast-induced acute kidney injury is a common complication in patients undergoing invasive procedures and is associated with increased mortality and morbidity. There is no effective approach to the management of this complication, and prevention remains of paramount importance. The 3 pillars of prevention are identification of high-risk patients, appropriate hydration before and after contrast exposure, eGFR-based contrast dosing and use of ultra-low contrast volume in high-risk patients. Most evidence supporting these practices is derived from patients undergoing coronary angiography or percutaneous coronary intervention but these basic principles can be applied to most patients undergoing contrast-based procedures in the catheterization laboratory.
Keywords:
Contrast-induced acute kidney injury; Renal function-based contrast dosing; Ultra-low contrast volume.
Copyright © 2020 Elsevier Inc. All rights reserved.
MeSH terms
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Acetylcysteine / administration & dosage
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Acetylcysteine / therapeutic use
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Acute Kidney Injury / chemically induced*
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Acute Kidney Injury / epidemiology
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Acute Kidney Injury / mortality
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Acute Kidney Injury / prevention & control*
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Case-Control Studies
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Catheterization / adverse effects*
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Catheterization / statistics & numerical data
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Contrast Media / administration & dosage
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Contrast Media / adverse effects*
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Coronary Angiography / adverse effects
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Coronary Angiography / methods
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Fluid Therapy / standards
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Free Radical Scavengers / administration & dosage
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Free Radical Scavengers / therapeutic use
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Glomerular Filtration Rate / drug effects
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Glomerular Filtration Rate / physiology
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
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Incidence
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Kidney / drug effects*
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Kidney / physiopathology
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Laboratories / statistics & numerical data
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Percutaneous Coronary Intervention / adverse effects
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Percutaneous Coronary Intervention / methods
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Randomized Controlled Trials as Topic
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Risk Factors
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Risk Reduction Behavior
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Rosuvastatin Calcium / administration & dosage
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Rosuvastatin Calcium / therapeutic use
Substances
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Contrast Media
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Free Radical Scavengers
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Rosuvastatin Calcium
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Acetylcysteine