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Contrast nephropathy in children.

Priya S Verghese1,2

  • 1University of Minnesota Children's Hospital, Minneapolis, MN, USA.

Journal of Pediatric Intensive Care
|June 20, 2019
PubMed
Summary
This summary is machine-generated.

Contrast-induced nephropathy (CIN) is a serious risk for patients undergoing contrast procedures. Intravenous fluids and avoiding nephrotoxic drugs are key preventive measures, while other treatments show limited efficacy.

Keywords:
Contrast-induced nephropathyacute kidney injuryacute renal failure

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Area of Science:

  • Nephrology
  • Radiology
  • Cardiology

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication following contrast agent administration.
  • Risk factors for CIN are cumulative and include chronic kidney disease, hypotension, and diabetes mellitus.
  • Effective pre-procedural risk stratification is crucial for managing patients at risk.

Purpose of the Study:

  • To review and evaluate various strategies for reducing the incidence of CIN.
  • To identify effective preventive measures and assess the efficacy of different pharmacological agents.

Main Methods:

  • Review of existing literature on CIN prevention strategies.
  • Analysis of risk factors and their additive effects.
  • Evaluation of intravenous volume expansion, drug withdrawal, and adjunctive medical treatments.

Main Results:

  • Intravenous hydration with isotonic crystalloids is a proven method to reduce CIN probability.
  • Withholding nephrotoxic medications before contrast exposure is recommended.
  • Many adjunctive treatments, including hemodialysis and specific drugs like N-acetylcysteine and dopamine, have not demonstrated efficacy.
  • Theophylline, statins, ascorbic acid, and prostaglandin E warrant further investigation.

Conclusions:

  • Intravenous fluid administration and careful patient selection are paramount in preventing CIN.
  • Minimizing contrast volume and using non-ionic iso-osmolar agents are important when contrast is unavoidable.
  • Further research is needed for pharmacological agents like theophylline, statins, ascorbic acid, and prostaglandin E.