[对比诱导的脏病:一个真正的问题还是神话?]
Silke Fortenbacher1, Stefan John2
1Klinik für Kardiologie, Abteilung für Internistische Intensivmedizin, Klinikum Nürnberg, Campus Süd, Paracelsus Medizinische Privatuniversität, Breslauer Str. 201, 90471, Nürnberg, Deutschland. silke.fortenbacher@klinikum-nuernberg.de.
Die Anaesthesiologie
|March 2, 2026
概括
对比剂诱导的急性损伤 (CI-AKI) 的风险是过高估计的. 患者的因素,如败血症和病,而不是对比,是主要的AKI驱动因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是指放射学
- 麻醉学 麻醉学
背景情况:
- 对比诱导的急性损伤 (CI-AKI) 被认为是有的对比介质的显著并发症.
- 最近的数据表明,与CI-AKI相关的风险可能被严重高估.
研究的目的:
- 批判性地评估对比介质在急性损伤 (AKI) 中的作用的证据.
- 重新评估对比剂在多因素AKI发展中的临床相关性.
主要方法:
- 选择的临床研究和元分析的叙述和评论驱动的分析.
- 评估重点是患者相关的风险因素和术后和重症监护机构的实际方面.
主要成果:
- 大多数研究表明,有的对比介质和AKI之间没有或只有边际的因果关系.
- AKI发生与患者因素相关:慢性病,血液动力学不稳定,败血症和炎症.
- 对比介质往往标志着严重的疾病,而不是引发AKI.
结论:
- 含对比剂的假定毒性需要重新评估.
- 焦点应该从避免对比转移到器官 perfusion 和血液动力学稳定性.
- 合理的,基于证据的对比度使用是必不可少的,避免诊断延迟.
相关概念视频
Nephrotic Syndrome I : Introduction
778
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
778
Acute Kidney Injury IV: Diagnostic Studies and Prevention
397
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
397
Nephrons
7.7K
The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
7.7K
Chronic Kidney Disease I: Introduction
872
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
872
Acute Kidney Injury II: Pathophysiology
1.4K
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
1.4K
Chronic Kidney Disease II: Clinical Manifestations
807
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
807


