Limb Ischemia Protects Against Contrast-Induced Nephropathy.
Circulation. 2012 Jun 26;
Authors: Bonventre JV
Contrast-induced acute kidney injury (AKI), or nephropathy, (CIN) is frequently diagnosed in the setting of coronary angiography. The incidence varies in the literature partly related to the differences in diagnostic criteria used for CIN. In a recently published manuscript in Circulation Maioli et al.(1) used a definition of Ã¢ÂÂ¥ 0.5 mg/dl over baseline serum creatinine within 3 days of the administration of contrast medium and found an incidence of 12.1 % among 1490 patients who had an baseline estimated creatinine clearance of <60 ml/min. It has become increasingly recognized that even mild forms of AKI are associated with adverse short and long term outcomes including onset or progression of chronic kidney disease and more rapid progression to end stage kidney disease(2,3). Patients with CIN have an increase in short-term and long-term mortality, whether the renal dysfunction is acute or chronic and after adjustments for other comorbidities(4). While it has been concluded by many that the development of CIN may identify other comorbidities that are more responsible for the adverse outcomes, there are increasing data from randomized trials that CIN may directly contribute to the increased risk of cardiovascular and renal adverse outcomes(5). (SELECT FULL TEXT TO CONTINUE).
PMID: 22735307 [PubMed - as supplied by publisher]