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Acute kidney injury by radiographic contrast media: pathogenesis and prevention.

Andreucci M, Faga T, Pisani A, Sabbatini M, Michael A - Biomed Res Int (2014)

Bottom Line: It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes.The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury.However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Unit, Department of Health Sciences, "Magna Graecia" University, Campus "Salvatore Venuta", Viale Europa, Località Germaneto, 88100 Catanzaro, Italy.

ABSTRACT
It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24-72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both.

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Related in: MedlinePlus

The complex mechanisms that lead to radiocontrast-associated decline of GFR. The dotted arrows indicate the reaction of the reactive oxygen species (ROS) (superoxide anions: O2∙−) with nitric oxide (NO) that not only causes a reduction in NO levels but also leads to the formation of peroxynitrite anion (ONOO−), a potent oxidant that causes cell injury.
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fig1: The complex mechanisms that lead to radiocontrast-associated decline of GFR. The dotted arrows indicate the reaction of the reactive oxygen species (ROS) (superoxide anions: O2∙−) with nitric oxide (NO) that not only causes a reduction in NO levels but also leads to the formation of peroxynitrite anion (ONOO−), a potent oxidant that causes cell injury.

Mentions: The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors (Figure 1). When iodinated radiographic contrast media are injected intravenously or intra-arterially, they pass from the vascular compartment through capillaries into the extracellular space. They are eliminated almost entirely by glomerular filtration, concentrated in the renal tubular lumen by water tubular reabsorption, thereby visualizing the urinary tract [1].


Acute kidney injury by radiographic contrast media: pathogenesis and prevention.

Andreucci M, Faga T, Pisani A, Sabbatini M, Michael A - Biomed Res Int (2014)

The complex mechanisms that lead to radiocontrast-associated decline of GFR. The dotted arrows indicate the reaction of the reactive oxygen species (ROS) (superoxide anions: O2∙−) with nitric oxide (NO) that not only causes a reduction in NO levels but also leads to the formation of peroxynitrite anion (ONOO−), a potent oxidant that causes cell injury.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150431&req=5

fig1: The complex mechanisms that lead to radiocontrast-associated decline of GFR. The dotted arrows indicate the reaction of the reactive oxygen species (ROS) (superoxide anions: O2∙−) with nitric oxide (NO) that not only causes a reduction in NO levels but also leads to the formation of peroxynitrite anion (ONOO−), a potent oxidant that causes cell injury.
Mentions: The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors (Figure 1). When iodinated radiographic contrast media are injected intravenously or intra-arterially, they pass from the vascular compartment through capillaries into the extracellular space. They are eliminated almost entirely by glomerular filtration, concentrated in the renal tubular lumen by water tubular reabsorption, thereby visualizing the urinary tract [1].

Bottom Line: It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes.The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury.However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors.

View Article: PubMed Central - PubMed

Affiliation: Nephrology Unit, Department of Health Sciences, "Magna Graecia" University, Campus "Salvatore Venuta", Viale Europa, Località Germaneto, 88100 Catanzaro, Italy.

ABSTRACT
It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24-72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both.

Show MeSH
Related in: MedlinePlus