Contrast-induced nephropathy (Pharmacology of X-ray contrast agents)

Abstract


In the last 30 years the use of X-ray contrast media (RCM) has increased significantly during urography, angiography, computed tomography, and operating procedures. Every year the world uses about 60 million doses of PKM, but, despite the use of newer and less nephrotoxic drugs, the risk of contrast-induced nephropathy (CIN) is still significant, especially among patients with prior renal impairment. Contrast induced nephropathy is a major cause of acute renal injury and is a huge problema in clinical practice. So far, con-tradictions remain in the understanding of many aspects of CIN. Contrast-induced nephropathy is acute renal failure (ARF) occurs within 48-72 hours after intravenous administration of contrast sub-stances. Toxicity PKC determined their molecular structure and its ability to dissociate in aqueous solution into ions which consist of salts which dissociate into cations and anions. The contrast-induced nephropathy is manifested in the increase of serum creatinine of 44 mmol/L (0.5 mg / dl) or more and the same rise in serum creatinine of more than 25 % compared to baseline in the absence of other possible causes. ARF is a sudden and sustained reduction in glomerular filtration rate and urine volume, or both together. Thus renal dysfunction existing even more than 1 month can be regarded as acute renal dysfunction. Usually the development of acute renal failure occurs within 1-7 days. The criteria of sustainability is a dysfunction of its registration within 24 hours or more. The aim: to consider different approaches to the pathogenesis, risk factors and achievements in the prevention of contrast-induced nephropathy.

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About the authors

Vladislava A Raptanova

First St. Petersburg State Medical University

Email: vladislavaraptanova@yandex.ru
Doctor-Intern, the Department of Radiology and Radiation Medicine with Division of Rentgenology. State Budget Educational Institution “The First St. Petersburg State Medical University”.

Alexandra A Speranskaya

First St. Petersburg State Medical University

Email: vladislavaraptanova@yandex.ru
MD, PhD, Dr Med Sci, Professo. Department of Radiology and Radiation Medicine with Division of Rentgenology. State Budget Educational Institution “The First St. Petersburg State Medical University”.

Sergei N Proshin

Saint Petersburg State Pediatric Medical University of Health Ministry of Russia

Email: psnjsn@rambler.ru
MD, PhD, Dr Med Sci, Professor, Head of the Department of Pharmacology. St. Petersburg State Pediatric Medical University.

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Copyright (c) 2016 Raptanova V.A., Speranskaya A.A., Proshin S.N.

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