Strategies to reduce the risk of contrast nephropathy: An evidence-based approach

Current Opinion in Nephrology and Hypertension

Volumn 15, Issue 3, 2006, Pages 285-290

  Pannu, Neesh ^a,c   Tonelli, Marcello ^a,b  

^a UNIVERSITY OF ALBERTA   (Canada)

^b INSTITUTE OF HEALTH ECONOMICS   (Canada)

^c 11 107 Clinical Sciences Building ^*  (Canada)

Author keywords

Acute renal failure; Angiography; Contrast nephropathy; Prevention; Radiocontrast nephrotoxicity

Indexed keywords

ACETYLCYSTEINE; ASCORBIC ACID; CONTRAST MEDIUM; CREATININE; FENOLDOPAM; IOHEXOL; IOVERSOL; IOXAGLIC ACID; THEOPHYLLINE;

ANGIOGRAPHY; CLINICAL TRIAL; DATA ANALYSIS; DRUG EFFECT; DRUG EFFICACY; DRUG TREATMENT FAILURE; HIGH RISK PATIENT; HIGH RISK POPULATION; HUMAN; HYDRATION; KIDNEY DISEASE; NEPHROTOXICITY; NONHUMAN; OSMOLALITY; PATHOGENESIS; PATHOPHYSIOLOGY; PRECAMBRIAN; PREDICTION; PRIORITY JOURNAL; PROPHYLAXIS; REHYDRATION; RENAL PROTECTION; REVIEW;

ACETYLCYSTEINE; ASCORBIC ACID; CONTRAST MEDIA; EVIDENCE-BASED MEDICINE; FENOLDOPAM; HUMANS; KIDNEY DISEASES; OSMOLAR CONCENTRATION; RISK FACTORS; THEOPHYLLINE;

EID: 33646786424     PISSN: 10624821     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.mnh.0000222696.92088.28     Document Type: Review

References (50)

1. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002; 39:930-936.
2. Levy EM, Viscoli CM, Horwitz RI. The effect of acute renal failure on mortality: a cohort analysis. JAMA 1996; 275:1489-1494.
3. Rihal CS, Textor SC, Grill DE, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105:2259-2264.
4. McCullough PA, Sandberg KR. Epidemiology of contrast-induced nephropathy. Rev Cardiovasc Med 2003; 4 (Suppl 5):S3-S9.
5. Barrett BJ, Parfrey PS, Vavasour HM, et al. Contrast nephropathy in patients with impaired renal function: high versus low osmolar media. Kidney Int 1992; 41:1274-1279.
6. Lasser EC, Lyon SG, Berry CC. Reports on contrast media reactions: analysis of data from reports to the US Food and Drug Administration. Radiology 1997; 203:605-610.
7. Mueller C, Seidensticker P, Buettner HJ, et al. Incidence of contrast nephropathy in patients receiving comprehensive intravenous and oral hydration. Swiss Med Wkly 2005; 135:286-290.
8. Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004; 44:1393-1399.
9. Spargias K, Alexopoulos E, Kyrzopoulos S, et al. Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. Circulation 2004; 110:2837-2842.
10. Detrenis S, Meschi M, Musini S, Savazzi G. Lights and shadows on the pathogenesis of contrast-induced nephropathy: state of the art. Nephrol Dial Transplant 2005; 20:1542-1550. A well writtten brief review of our current knowledge in this area.
11. Persson PB, Hansell P, Liss P. Pathophysiology of contrast medium-induced nephropathy. Kidney Int 2005; 68:14-22. Another, more detailed review of our current understanding of the pathophysiology of contrast nephropathy.
12. Liss P, Nygren A, Erikson U, Ulfendahl HR. Injection of low and iso-osmolar contrast medium decreases oxygen tension in the renal medulla. Kidney Int 1998; 53:698-702.
13. Ueda J, Furukawa T, Higashino K, et al. Urine viscosity after injections of iotrolan or iomeprol. Acta Radiol 1997; 38:1079-1082.
14. Sharma SK, Kini A. Effect of nonionic radiocontrast agents on the occurrence of contrast-induced nephropathy in patients with mild-moderate chronic renal insufficiency: pooled analysis of the randomized trials. Catheter Cardiovasc Interv 2005; 65:386-393. This pooled analysis forces us to reexamine the results of previous clinical trials, as the type of contrast agent used appears to be vitally important in predicting the risk of nephrotoxicity.
15. ••] findings, and the author further speculates that viscosity may be a major mechanism of nephrotoxicity.
16. Briguori C, Colombo A, Airoldi F, et al. Nephrotoxicity of low-osmolality versus iso-osmolality contrast agents: impact of N-acetylcysteine. Kidney Int 2005; 68:2250-2255.
17. Arstall MA, Yang J, Stafford I, et al. N-acetylcysteine in combination with nitroglycerin and streptokinase for the treatment of evolving acute myocardial infarction: safety and biochemical effects. Circulation 1995; 92:2855-2862.
18. Brunet J, Boily MJ, Cordeau S, Des RC. Effects of N-acetylcysteine in the rat heart reperfused after low-flow ischemia: evidence for a direct scavenging of hydroxyl radicals and a nitric oxide-dependent increase in coronary flow. Free Radic Biol Med 1995; 19:627-638.
19. Safirstein R, Andrade L, Vieira JM. Acetylcysteine and nephrotoxic effects of radiographic contrast agents: a new use for an old drug. N Engl J Med 2000; 343:210-212.
20. Pannu N, Manns B, Lee H, Tonelli M. Systematic review of the impact of N-acetylcysteine on contrast nephropathy. Kidney Int 2004; 65:1366-1374.
21. Bagshaw SM, Ghali WA. Acetylcysteine for prevention of contrast-induced nephropathy after intravascular angiography: a systematic review and meta-analysis. BMC Med 2004; 2:38.
22. Liu R, Nair D, Ix J, et al. N-acetylcysteine for the prevention of contrast-induced nephropathy: a systematic review and meta-analysis. J Gen Intern Med 2005; 20:193-200.
23. Duong MH, MacKenzie TA, Malenka DJ. N-acetylcysteine prophylaxis significantly reduces the risk of radiocontrast-induced nephropathy: comprehensive meta-analysis. Catheter Cardiovasc Interv 2005; 64:471-479.
24. Nallamothu BK, Shojania KG, Saint S, et al. Is acetylcysteine effective in preventing contrast-related nephropathy? A meta-analysis. Am J Med 2004; 117:938-947.
25. Birck R, Krzossok S, Markowetz F, et al. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet 2003; 362:598-603.
26. Isenbarger DW, Kent SM, O'Malley PG. Meta-analysis of randomized clinical trials on the usefulness of acetylcysteine for prevention of contrast nephropathy. Am J Cardiol 2003; 92:1454-1458.
27. Alonso A, Lau J, Jaber BL, et al. Prevention of radiocontrast nephropathy with N-acetylcysteine in patients with chronic kidney disease: a meta-analysis of randomized, controlled trials. Am J Kidney Dis 2004; 43:1-9.
28. Misra D, Leibowitz K, Gowda RM, et al. Role of N-acetylcysteine in prevention of contrast-induced nephropathy after cardiovascular procedures: a meta-analysis. Clin Cardiol 2004; 27:607-610.
29. Kshirsagar AV, Poole C, Mottl A, et al. N-acetylcysteine for the prevention of radiocontrast induced nephropathy: a meta-analysis of prospective controlled trials. J Am Soc Nephrol 2004; 15:761-769.
30. Guru V, Fremes SE. The role of N-acetylcysteine in preventing radiographic contrast-induced nephropathy. Clin Nephrol 2004; 62:77-83.
31. Miner SE, Dzavik V, Nguyen-Ho P, et al. N-acetylcysteine reduces contrast-associated nephropathy but not clinical events during long-term follow-up. Am Heart J 2004; 148:690-695.
32. Webb JG, Pate GE, Humphries KH, et al. A randomized controlled trial of intravenous N-acetylcysteine for the prevention of contrast-induced nephropathy after cardiac catheterization: lack of effect. Am Heart J 2004; 148:422-429.
33. Gomes VO, Poli de Figueredo CE, Caramori P, L et al. N-acetylcysteine does not prevent contrast induced nephropathy after cardiac catheterisation with an ionic low osmolality contrast medium: a multicentre clinical trial. Heart 2005; 91:774-778.
34. Azmus AD, Gottschall C, Manica A, et al. Effectiveness of acetylcysteine in prevention of contrast nephropathy. J Invasive Cardiol 2005; 17:80-84.
35. Rashid ST, Salman M, Myint F, et al. Prevention of contrast-induced nephropathy in vascular patients undergoing angiography: a randomized controlled trial of intravenous N-acetylcysteine. J Vasc Surg 2004; 40:1136-1141.
36. Briguori C, Colombo A, Violante A, et al. Standard vs double dose of N-acetylcysteine to prevent contrast agent associated nephrotoxicity. Eur Heart J 2004; 25:206-211.
37. Bakris GL, Lass NA, Glock D. Renal hemodynamics in radiocontrast medium-induced renal dysfunction: a role for dopamine-1 receptors. Kidney Int 1999; 56:206-210.
38. Tumlin JA, Wang A, Murray PT, Mathur VS. Fenoldopam mesylate blocks reductions in renal plasma flow after radiocontrast dye infusion: a pilot trial in the prevention of contrast nephropathy. Am Heart J 2002; 143:894-903.
39. Stone GW, McCullough PA, Tumlin JA, et al. Fenoldopam mesylate for the prevention of contrast-induced nephropathy: a randomized controlled trial. JAMA 2003; 290:2284-2291.
40. Briguori C, Colombo A, Airoldi F, et al. N-acetylcysteine versus fenoldopam mesylate to prevent contrast agent-associated nephrotoxicity. J Am Coll Cardiol 2004; 44:762-765.
41. Ng TM, Shurmur SW, Silver M, N et al. Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN). Int J Cardiol 2005; July 21. [Epub ahead of print] A randomized controlled trial terminated early for futility after interim analysis showed no significant difference between N-acetylcysteine and fenoldopam.
42. Asif A, Epstein DL, Epstein M. Dopamine-1 receptor agonist: renal effects and its potential role in the management of radiocontrast-induced nephropathy. J Clin Pharmacol 2004; 44:1342-1351.
43. Ix JH, McCulloch CE, Chertow GM. Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis. Nephrol Dial Transplant 2004; 19:2747-2753.
44. Bagshaw SM, Ghali WA. Theophylline for prevention of contrast-induced nephropathy: a systematic review and meta-analysis. Arch Intern Med 2005; 165:1087-1093. A well written, careful analysis of theophylline trials to date. Authors warn against overinterpretation of results, as there was considerable heterogeneity in the study.
45. Lloberas N, Torras J, Herrero-Fresneda I, et al. Postischemic renal oxidative stress induces inflammatory response through PAF and oxidized phospholipids: prevention by antioxidant treatment. FASEB J 2002; 16:908-910.
46. Durak I, Ozbek H, Karaayvaz M, Ozturk HS. Cisplatin induces acute renal failure by impairing antioxidant system in guinea pigs: effects of antioxidant supplementation on the cisplatin nephrotoxicity. Drug Chem Toxicol 2002; 25:1-8.
47. Ali BH. Agents ameliorating or augmenting experimental gentamicin nephrotoxicity: some recent research. Food Chem Toxicol 2003; 41:1447-1452.
48. Mueller C, Buerkle G, Buettner HJ, et al. Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med 2002; 162:329-336.
49. Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 2004; 291:2328-2334.
50. Marenzi G, Marana I, Lauri G, et al. The prevention of radiocontrast-agent-induced nephropathy by hemofiltration. N Engl J Med 2003; 349:1333-1340.