Contrast-induced nephropathy and its prevention: What do we really know from evidence-based findings?

Hdl Handle:
http://hdl.handle.net/10147/94204
Title:
Contrast-induced nephropathy and its prevention: What do we really know from evidence-based findings?
Authors:
Reddan, Donald; Laville, Maurice; Garovic, Vesna D
Affiliation:
University College Galway, Merlin Park Hospital, Galway - Ireland.
Citation:
Contrast-induced nephropathy and its prevention: What do we really know from evidence-based findings?, 22 (3):333-51 J. Nephrol.
Journal:
Journal of nephrology
Issue Date:
12-Mar-2010
URI:
http://hdl.handle.net/10147/94204
PubMed ID:
19557710
Abstract:
INTRODUCTION: Contrast-induced acute kidney injury, also referred to as contrast-induced nephropathy (CIN), is a potentially serious renal complication associated with the use of iodinated contrast media (CM) in patients at risk. With the dramatic growth in contrast-enhanced imaging services worldwide, including procedures involving exposure to iodinated CM, efforts to reduce the occurrence of CIN have received considerable attention in recent years. To date, these efforts have met with little success since the 12% prevalence of CIN today remains unchanged from 2 decades ago. METHODS: We conducted a systematic literature review of the most recent evidence available from published reports of contemporary (2000-2008) prospective, randomized, controlled trials that have investigated CIN either by comparing CM or by comparing preventive strategies. The objective was to critically review the findings in light of several aspects of study design and then to establish a set of parameters for consideration in the planning of future CIN trials so as to optimize the strength of evidence obtained. RESULTS: Whether future CIN trials are investigating comparative CM nephrotoxicity or dealing with prophylactic strategies for risk reduction, the complexities that must be addressed include a standardized definition of CIN, appropriate timing of SCr measurements with timing standardized for all subjects in a given study population, awareness of study population risk profile, hydration protocols, and pharmacological prophylactic strategies. CONCLUSIONS: Large, well-designed trials (ideally with hard clinical outcome measures) that consider all the complexities involved in CIN and its prevention are needed before the clinical community has the evidence-based direction required for optimized patient care.
Language:
en
MeSH:
Animals; Contrast Media; Creatinine; Humans; Kidney Diseases
ISSN:
1121-8428

Full metadata record

DC FieldValue Language
dc.contributor.authorReddan, Donalden
dc.contributor.authorLaville, Mauriceen
dc.contributor.authorGarovic, Vesna Den
dc.date.accessioned2010-03-12T15:42:31Z-
dc.date.available2010-03-12T15:42:31Z-
dc.date.issued2010-03-12T15:42:31Z-
dc.identifier.citationContrast-induced nephropathy and its prevention: What do we really know from evidence-based findings?, 22 (3):333-51 J. Nephrol.en
dc.identifier.issn1121-8428-
dc.identifier.pmid19557710-
dc.identifier.urihttp://hdl.handle.net/10147/94204-
dc.description.abstractINTRODUCTION: Contrast-induced acute kidney injury, also referred to as contrast-induced nephropathy (CIN), is a potentially serious renal complication associated with the use of iodinated contrast media (CM) in patients at risk. With the dramatic growth in contrast-enhanced imaging services worldwide, including procedures involving exposure to iodinated CM, efforts to reduce the occurrence of CIN have received considerable attention in recent years. To date, these efforts have met with little success since the 12% prevalence of CIN today remains unchanged from 2 decades ago. METHODS: We conducted a systematic literature review of the most recent evidence available from published reports of contemporary (2000-2008) prospective, randomized, controlled trials that have investigated CIN either by comparing CM or by comparing preventive strategies. The objective was to critically review the findings in light of several aspects of study design and then to establish a set of parameters for consideration in the planning of future CIN trials so as to optimize the strength of evidence obtained. RESULTS: Whether future CIN trials are investigating comparative CM nephrotoxicity or dealing with prophylactic strategies for risk reduction, the complexities that must be addressed include a standardized definition of CIN, appropriate timing of SCr measurements with timing standardized for all subjects in a given study population, awareness of study population risk profile, hydration protocols, and pharmacological prophylactic strategies. CONCLUSIONS: Large, well-designed trials (ideally with hard clinical outcome measures) that consider all the complexities involved in CIN and its prevention are needed before the clinical community has the evidence-based direction required for optimized patient care.-
dc.language.isoenen
dc.subject.meshAnimals-
dc.subject.meshContrast Media-
dc.subject.meshCreatinine-
dc.subject.meshHumans-
dc.subject.meshKidney Diseases-
dc.titleContrast-induced nephropathy and its prevention: What do we really know from evidence-based findings?en
dc.contributor.departmentUniversity College Galway, Merlin Park Hospital, Galway - Ireland.en
dc.identifier.journalJournal of nephrologyen
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