Navigating Nephrotoxic Waters: A Comprehensive Overview of Contrast-induced Acute Kidney Injury Prevention

Overview

Journal World J Radiol

Publisher Baishideng Publishing Group

Specialty Radiology

Date 2024 Jul 10

PMID 38983842

Authors

Panagiotis Theofilis

Rigas Kalaitzidis

Affiliations

Soon will be listed here.

Abstract

Contrast-induced acute kidney injury (CI-AKI) is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality. Its pathophysiology, although not well-established, revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney. Critically ill patients, as well as those with pre-existing renal disease and cardiovascular comorbidities, are more susceptible to CI-AKI. Despite the continuous research in the field of CI-AKI prevention, clinical practice is based mostly on periprocedural hydration. In this review, all the investigated methods of prevention are presented, with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

Citing Articles

Innovative approaches beyond periprocedural hydration for preventing contrast-induced acute kidney injury.

Cheng C, Hao W, Cheng T World J Radiol. 2024; 16(9):375-379.

PMID: 39355388 PMC: 11440278. DOI: 10.4329/wjr.v16.i9.375.

References

Palli E, Makris D, Papanikolaou J, Garoufalis G, Tsilioni I, Zygoulis P . The impact of N-acetylcysteine and ascorbic acid in contrast-induced nephropathy in critical care patients: an open-label randomized controlled study. Crit Care. 2017; 21(1):269. PMC: 5664844. DOI: 10.1186/s13054-017-1862-3. View

Marashizadeh A, Sanati H, Sadeghipour P, Peighambari M, Moosavi J, Shafe O . Left ventricular end-diastolic pressure-guided hydration for the prevention of contrast-induced acute kidney injury in patients with stable ischemic heart disease: the LAKESIDE trial. Int Urol Nephrol. 2019; 51(10):1815-1822. DOI: 10.1007/s11255-019-02235-w. View

Mirza A, Ali K, Huwez F, Taha A, Ahmed F, Ezzaddin S . Contrast Induced Nephropathy: Efficacy of matched hydration and forced diuresis for prevention in patients with impaired renal function undergoing coronary procedures-CINEMA trial. Int J Cardiol Heart Vasc. 2022; 39:100959. PMC: 8818567. DOI: 10.1016/j.ijcha.2022.100959. View

Bouzas-Mosquera A, Vazquez-Rodriguez J, Calvino-Santos R, Peteiro-Vazquez J, Flores-Rios X, Marzoa-Rivas R . [Contrast-induced nephropathy and acute renal failure following emergent cardiac catheterization: incidence, risk factors and prognosis]. Rev Esp Cardiol. 2007; 60(10):1026-34. DOI: 10.1157/13111234. View

Margulies K, Burnett Jr J . Atrial natriuretic factor modulates whole kidney tubuloglomerular feedback. Am J Physiol. 1990; 259(1 Pt 2):R97-101. DOI: 10.1152/ajpregu.1990.259.1.R97. View

Lombardi M, Molisana M, Genovesi E, De Innocentiis C, Limbruno U, Misuraca L . Urine alkalinisation to prevent contrast-induced acute kidney injury: the prospective, randomised, controlled, open-label TEATE trial. EuroIntervention. 2022; 18(7):562-573. DOI: 10.4244/EIJ-D-22-00010. View

Carraro M, Mancini W, Artero M, Stacul F, GROTTO M, Cova M . Dose effect of nitrendipine on urinary enzymes and microproteins following non-ionic radiocontrast administration. Nephrol Dial Transplant. 1996; 11(3):444-8. View

Mehran R, Aymong E, Nikolsky E, Lasic Z, Iakovou I, Fahy M . A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004; 44(7):1393-9. DOI: 10.1016/j.jacc.2004.06.068. View

Spargias K, Adreanides E, Demerouti E, Gkouziouta A, Manginas A, Pavlides G . Iloprost prevents contrast-induced nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. Circulation. 2009; 120(18):1793-9. DOI: 10.1161/CIRCULATIONAHA.109.863159. View

10.

Keaney J, Hannon C, Murray P . Contrast-induced acute kidney injury: how much contrast is safe?. Nephrol Dial Transplant. 2013; 28(6):1376-83. DOI: 10.1093/ndt/gfs602. View

11.

Nijssen E, Rennenberg R, Nelemans P, Essers B, Janssen M, Vermeeren M . Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Lancet. 2017; 389(10076):1312-1322. DOI: 10.1016/S0140-6736(17)30057-0. View

12.

Marenzi G, Assanelli E, Campodonico J, Lauri G, Marana I, De Metrio M . Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality. Ann Intern Med. 2009; 150(3):170-7. DOI: 10.7326/0003-4819-150-3-200902030-00006. View

13.

Ghelich Khan Z, Talasaz A, Pourhosseini H, Hosseini K, Ansari M, Jalali A . Potential Role of Allopurinol in Preventing Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention: A Randomized Placebo-Controlled Trial. Clin Drug Investig. 2017; 37(9):853-860. DOI: 10.1007/s40261-017-0542-z. View

14.

Xu H, Wang H, Zhang C, Xiao J, Hua N, Tang X . Efficacy of Alprostadil in Preventing Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis. Angiology. 2021; 72(9):878-888. DOI: 10.1177/00033197211004412. View

15.

Liss P, Nygren A, Erikson U, ULFENDAHL H . Injection of low and iso-osmolar contrast medium decreases oxygen tension in the renal medulla. Kidney Int. 1998; 53(3):698-702. DOI: 10.1046/j.1523-1755.1998.00811.x. View

16.

Azzalini L, Mitomo S, Hachinohe D, Regazzoli D, Colombo A . Zero-Contrast Percutaneous Coronary Intervention Guided by Dextran-Based Optical Coherence Tomography. Can J Cardiol. 2018; 34(3):342.e1-342.e3. DOI: 10.1016/j.cjca.2017.11.008. View

17.

Kurnik B, Allgren R, Genter F, Solomon R, Bates E, Weisberg L . Prospective study of atrial natriuretic peptide for the prevention of radiocontrast-induced nephropathy. Am J Kidney Dis. 1998; 31(4):674-80. DOI: 10.1053/ajkd.1998.v31.pm9531185. View

18.

SCANLON P, Faxon D, Audet A, Carabello B, Dehmer G, Eagle K . ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac.... J Am Coll Cardiol. 1999; 33(6):1756-824. DOI: 10.1016/s0735-1097(99)00126-6. View

19.

Briguori C, Golino M, Porchetta N, Scarpelli M, De Micco F, Rubino C . Impact of a contrast media volume control device on acute kidney injury rate in patients with acute coronary syndrome. Catheter Cardiovasc Interv. 2020; 98(1):76-84. DOI: 10.1002/ccd.29136. View

20.

Vogt B, Ferrari P, Schonholzer C, Marti H, Mohaupt M, Wiederkehr M . Prophylactic hemodialysis after radiocontrast media in patients with renal insufficiency is potentially harmful. Am J Med. 2001; 111(9):692-8. DOI: 10.1016/s0002-9343(01)00983-4. View