Methods for Reducing Contrast Use and Avoiding Acute Kidney Injury During Endovascular Procedures

Author(s): Chrysovalantis Vergadis*, Georgios Festas, Eleni Spathi, Paris Pappas, Stavros Spiliopoulos.

Journal Name: Current Pharmaceutical Design

Volume 25 , Issue 44 , 2019

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Abstract:

Iodinated Contrast Media (CM) has a plethora of applications in routine non-invasive or percutaneous invasive imaging examinations and therapeutic interventions. Unfortunately, the use of CM is not without complications, with contrast-induced acute kidney injury (CI-AKI) being among the most severe.

CI-AKI is a syndrome defined as a rapid development of renal impairment after a few days of CM endovascular injection, without the presence of any other underlying related pathologies. Although mostly transient and reversible, for a subgroup of patients with comorbidities related to renal failure, CI-AKI is directly leading to longer hospitalization, elevated rates of morbidity and mortality, as well as the increased cost of funding.

Thus, a need for classification in accordance with clinical and peri-procedural criteria is emerged. This would be very useful for CI-AKI patients in order to predict the ones who would have the greatest advantage from the application of preventive strategies.

This article provides a practical review of the recent evidence concerning CI-AKI incidence, diagnosis, and sheds light on prevention methods for reducing contrast use and avoiding AKI during endovascular procedures.

In conclusion, despite the lack of a specific treatment protocol, cautious screening, assessment, identification of the high-risk patients, and thus the application of simple interventions -concerning modifiable risk factors- can significantly reduce CI-AKI risk.

Keywords: Contrast-induced acute kidney injury, prevention, risk score, chronic kidney disease, iodinated contrast media, high-risk patients.

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