ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2014;3(2):51-56.
doi:10.12860/jnp.2014.12
PMID: 24772397
PMCID: PMC3999584

Scopus id: 84909980104

Short Review Article

Contrast-induced nephropathy; A literature review

Jafar Golshahi 1, Hamid Nasri 2, Mojgan Gharipour 3 *

1 Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Isfahan Cardiovascular Research Centre, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Corresponding author: Mojgan Gharipour, Isfahan Cardiovascular Research Centre, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Email: Gharipour@crc.mui.ac.ir

Abstract

Context: Contrast–induced nephropathy (CIN) is a common cause of acute kidney dysfunction.

Evidence Acquisitions: Directory of Open Access Journals, Google Scholar, PubMed, EBSCO and Web of Science have been searched.

Results: It is necessary to identify at risk patients at early stages to implement preventive strategies to decrease the incidence of this nephropathy. However, mechanisms of CIN have not fully explained yet. It seems that mechanisms which mediated by nitric oxide and prostaglandin-induced vasodilatation have been played a crucial role in the CIN. Hemodynamic changes of renal blood flow, which causes hypoxia in the renal medulla and direct toxic effects of contrast media on renal cells, are thought to contribute to the pathogenesis of CIN. Contrast media is normally divided into iso-osmolar, low-osmolar, and high-osmolar. N-acetylcysteine is considered as one of the best choices to prevent CIN in high-risk groups.

Conclusions: The first aim to prevent CIN is identifying high-risk subjects and controlling associate risk factors. As significant differences existed between contrasts agents due to their physicochemical properties, low-osmolar or iso-osmolar contrast media should be used to prevent CIN in at-risk patients. The volume of contrast media should be as low as possible.

Implication for health policy/practice/research/medical education:

Contrast-induced nephropathy is a common cause of acute renal functional impairment and accounts for significant morbidity and mortality. The primary goal should be avoiding contrast media to prevent contrast-induced nephropathy, if at all possible, and risk factors should be recognized. As significant differences between contrast agents due to their physicochemical properties exist, low-osmolar or iso-osmolar contrast media should be used to prevent contrast-induced nephropathy in at-risk patients. The volume of contrast media should be as low as possible.
Please cite this paper as: Golshahi J, Nasri H. Gharipour M. Contrast-induced nephropathy; A literature review. J Nephropathol. 2014; 3(2): 51-56. DOI: 10.12860/jnp.2014.12

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First published online: 01 Apr 2014
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