جستجوی مقالات مرتبط با کلیدواژه "contrast induced nephropathy" در نشریات گروه "پزشکی"

Contrast?induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention. This study aimed to compare the incidence of CIN in two groups of patients with and without metabolic syndrome (Mets) with baseline normal renal function.

In this case ? control study, 260 patient candidates for CAG, 130 patients with Mets and 130 patients without Mets participated, and
their serum creatinine (Cr) level before and the 48 and 72 h after the angiography was measured. The incidence of CIN was compared in two groups. Two?way nalysis of variance with repeated measures and univariate and multivariate logistic regression models.

The results showed a higher chance of being Mets with raising in riglyceride (adjusted odds ratio = 1.05, 95% confidence interval = (1.03–1.06), P < 0.001), Fasting blood glucose (1.010 [1.001–1.019], P = 0.025), and diastolic blood pressure (1.07 [1.07– 1.20], P < 0.001), but declining in high?density ipoprotein?cholesterol (HDL?C) (0.91 [0.85–0.98], P = 0.008). Furthermore, blood
urea nitrogen (BUN) and Cr level was raised in 48 and 72 h after contrast injection in both groups (All P < 0.001). Furthermore, in 48 h (3.11 [1.12–9.93], P = 0.016) and 72 h (2.82 [1.07–8.28], P = 0.021) after injection, a total of 25 patients had an increased Cr level and a significant difference between Mets and without Mets groups. The developing Mets had a significant association with the increased risk of AKI, which increased the chance of developing nephropathy (7.14 [2.27–22.5], P = 0.001).

Mets, together with other risk factors, increased the overall risk of CIN development. Therefore, the incidence of CIN in patients Mets is significantly higher than that of patients without Mets, indicating a more important CIN risk factor.

In the present study, we aimed to investigate the relationship between H2FPEF score and Contrast Induced Nephropathy (CIN) in patients with myocardial infarction with ST segment elevation (STEMI).

A total of 355 patients who had been diagnosed with ST elevation-myocardial infarction and undergone primary coronary angioplasty were retrospectively included in the study. The patients were divided into two groups according to the presence of CIN and these groups were compared in terms of baseline characteristics and laboratory findings. The H2FPEF score was calculated for each patient on admission and later compared between the groups.

The distribution of the study population was as following: 63 (17.7%) CIN (+) and 292 (82.2%) CIN (-). In CIN (+) group, the mean H2FPEF Score (2.00±1.60 vs 1.25±1.26, P<0.001) was significantly higher than the CIN (-) group. H2FPEF Score (OR: 1.25, 95%CI: 1.01-1.55), and mean age (OR: 1.03, 95%CI: 1.00-1.06) were found to be independently associated with CIN development.

H2FPEF score is an independent predictor of CIN development in patients with acute STEMI. It is easily calculated and and may be used to estimate the CIN in STEMI patients.

Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired acute kidney injury. The CIN prophylactic strategies adopted to date, although not highly efficient, are mostly based on antioxidant activity and hydration therapy. This study was designed and conducted to evaluate crocin’s efficacy in the prevention of CIN in chronic kidney disease (CKD) patients undergoing coronary angiography/angioplasty. In this randomized clinical trial, a total of 110 eligible CKD stage 3 patients requiring contrast agent administration for coronary angiography/angioplasty were enrolled and randomly assigned to either crocin (n = 57) or control (n = 53) group. The patients in both groups received standard hydration therapy; nevertheless, in the crocin group, the patients were also orally administered three consecutive oral doses of 30 mg crocin tablets 1 day before up to 1 day after contrast media (CM) exposure. The primary endpoint was CIN incidence defined as an increase in serum creatinine (SrCr) level by ≥ 0.3 mg/dL or any change in urinary neutrophil gelatinase-associated lipocalin (NGAL) from the baseline within 48 hours of CM exposure. During 4 months, 130 patients were recruited. The mean age of the patients was 65.62 ± 9.05 years, and the majority of them were male (64.54%). The SrCr in the crocin group did not significantly increase within 48 hours of angiography/angioplasty. The changes in the urinary NGAL level were not significant in both groups. The CIN incidence was significantly lower in the crocin group than in the control group (1.75% and 13.2%; P = 0.028). Crocin administration plays an important nephron-protective role in the prevention of CIN.

This retrospective cohort study aimed to evaluate the effects of the intravenous administration of vitamin C before and after exposure to the contrast medium for the prophylaxis of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. 

Data on 210 patients with chronic kidney disease (CKD) (defined as an estimated glomerular filtration rate ≤60 mL/min/1.73m2) were obtained through medical chart reviews and electronic data in 3 different groups: 1) no vitamin C administered, 2) vitamin C administered 30 minutes before angiography, and 3) vitamin C administered 30 minutes after angiography. Each group consisted of 70 patients, and vitamin C was administered intravenously. CIN incidence in all the groups was defined as an increase of 0.5 mg/dL or 25% in serum creatinine levels. 

Overall, CIN incidence was significantly lower in patients who received intravenous vitamin C before (P≤0.05) and after (P≤0.05) angiography than in patients with no prophylaxis. The post-angiography administration of vitamin C was very effective in diminishing creatinine rise and preventing CIN. CIN occurred in 7.1% of the patients in the pre-administered and post-administered groups. 

The intravenous administration of vitamin C before and after angiography could effectively decrease CIN incidence in patients undergoing percutaneous coronary intervention. The post-angiography administration of vitamin C is more effective to decrease serum creatinine levels. (Iranian Heart Journal 2022; 23(1): 149-159)

Contrast-induced nephropathy (CIN) is one of the most common reasons for acute kidney failure. Because of the increasing use of contrasts for computed tomography and angiography and coronary interventions, the incidence of CIN is on rise. CIN is a serious and common side effect ofthe use of contrasts. Despite taking of preventative measures, around 30-70% of patients are at risk of CIN. Researchers thus are seeking out appropriate approaches to prevent CIN. Positive effects of many medicinal plants, with antioxidant and anti-inflammatory properties and high efficiency and safety, in decreasing serum creatinine levels have been demonstrated. This study was conducted to collect evidence on the medicinal plants that are effective in decreasing serum creatinine levels and CINdevelopment

For this purpose, the key words contrast media, herbal, acute kidney injury, and nephropathy were used to retrieve relevant articles indexed in Google Scholar, Magiran, Elsevier, and PubMed. Then, the eligible articles were included in the review.

The results of studies are reported  in Table.

Although some studies have suggested that some herbs have a toxic effect on kidney function, in the present review, most plants could help decrease serum creatinine levels and improve renal function.

Contrast-induced nephropathy (CIN) is a significant common complication in patients undergoing coronary angiography. This study was carried out to determine the efficacy of remote ischemic preconditioning in the prevention of CIN in patients undergoing coronary angiography/angioplasty.
 
This randomized controlled trial assessed 171 eligible patients undergoing coronary angiography/angioplasty in Shariati Hospital between May 2018 and June 2019. The patients were randomly assigned to either the remote ischemic preconditioning group or the control group. The glomerular filtration rate (GFR), CIN, and creatinine levels were compared between the groups.
 
The incidence rate of CIN was 1.2% in the intervention group and 9.4% in the control group (P = 0.018), with a risk ratio of 0.125. There were significant improvements in creatinine and GFR in the intervention group (P = 0.007 and P = 0.001, respectively), while there were no meaningful improvements in creatinine and GFR in the control group. The intervention group featured 11 patients in Stage IV chronic kidney disease, none of whom was CIN-positive, whereas the control group had 2 patients in Stage IV, both of whom were CIN-positive (P < 0.001).
 
The results showed the efficacy of remote ischemic preconditioning in the prevention of CIN, the reduction of creatinine reduction, and the elevation of GFR in patients undergoing coronary angiography/angioplasty. (Iranian Heart Journal 2021; 22(1): 100-105)

Contrast-induced nephropathy (CIN) is an iatrogenic disease caused by the parenteral administration of iodinated contrast media (CM). A number of agents are currently being assessed to minimise or prevent CIN. Such agents are typically assessed using rat models. The aim of this study was to provide a comprehensive review of the rat models of CIN used in pre-clinical research. The MEDLINE, EMBASE, Web of Science and Cochrane databases were systematically searched. Articles reporting rat models of CIN were included for assessment. Study designs, contrast agents and outcome measures were assessed. Of the assessed studies, a majority report a requirement for pre-existing renal impairment prior to the administration of CM. Outcome measures are heterogenous between studies, but typically include assessment and quantification of serum biochemical markers, cellular oxidative stress and histopathological changes. The significant variation in methodology reported in the current literature highlights the lack of consensus. The use of a reliable pre-contrast insult appears critical to result in the development of contrast nephropathy. The use of acceptable outcome measures appears to include serum laboratory markers, quantification of reactive oxygen species (ROS) and objective histopathological outcomes.

The risk of contrast-induced nephropathy (CIN) as a common and important complication of coronary procedures may be influenced by the vascular access site. We compared the risks of CIN in diagnostic or interventional coronary management between patients treated via the transradial access (TRA) and those treated via the transfemoral access (TFA).

Patients undergoing invasive coronary catheterization or percutaneous coronary intervention (PCI) were enrolled. We excluded patients with congenital or structural heart disease and those with end-stage renal disease on dialysis. Based on the vascular access site used for invasive coronary catheterization, the patients were divided into 2 study groups: the TFA and the TRA. CIN was defined as an absolute (≥0.5 mg/dL) or relative (>25%) increase in the baseline serum creatinine level within 48 hours following cardiac catheterization or PCI.

Overall, 410 patients (mean age=61.3±10.8 years) underwent diagnostic or interventional coronary management: 258 were treated via the TFA approach and 152 via the TRA approach. The patients treated via the TFA had a significantly higher incidence of postprocedural CIN (15.1% vs 6.6%; P=0.01). The multivariate analysis showed that the TFA was the independent predictor of CIN (OR: 2.37, 95% CI: 1.11 to 5.10, and P=0.027). Moreover, the BARC (Bleeding Academic Research Consortium) and Mehran scores were the other independent predictors of CIN in our study.

The risk of CIN was lower with the TRA, and the TFA was the independent predictor of CIN after the diagnostic or interventional coronary management.

 Contrast induced nephropathy (CIN), a well-known complication of using radio contrast media, dramatically increases the likelihood of patient morbidity and mortality following coronary angiography. As there is no specific treatment for CIN, prevention could be the best strategy to address this issue. Since now, the only approved preventing strategy was hydration with normal saline while antioxidant agents as a new yet unapproved remedy for this purpose could be applied .The present study was conducted to examine the effect of alpha tocopherol in CIN prevention.

This prospective controlled trial was carried out on 201 patients with chronic kidney disease (eGFR < 60 cc/min) underwent coronary angiography. We assigned three groups of CKD patients: 72 patients who received prophylaxis administration with isotonic saline (Group A), 66 patients with isotonic saline plus N-acetylcysteine (1200mg twice a day) for 2 days (Group B) and 63 patients who received isotonic saline plus daily alpha tocopherol (600 IU once daily from one day before till 2 days after angiography) for 4 days (Group C). The contrast media in all three groups was nonionic iso-osmolal agent, Visipaque.

Even though CIN didn’t developed in any of the three aforementioned groups but there was statistically significant reduction in eGFR from baseline in all three groups (P < .001). Moreover, We found no statistically significant difference in GFR reduction between three studied groups.

Administration of alpha tocopherol has no additive beneficial effect over isotonic saline in CIN prevention in CKD patients

Contrast-induced acute kidney injury (CIN-AKI) is a serious complication of coronary angiography. Given the weaknesses in the common protective methods used to prevent CIN-AKI, a safe and effective strategy is needed. RIPC has been shown to have a nephroprotective effect.

We aimed to determine the protective effect of RIPC on CIN-AKI after angiography or percutaneous coronary intervention (PCI) in low-risk patients.

In our study, 140 low-risk patients who needed angiography or PCI, were assigned to either RIPC or control group. In each group, serum creatinine and urinary neutrophil gelatinaseassociated lipocalin (uNGAL) were measured before the procedure. Serum creatinine was measured daily for 2 days and uNGAL was measured 6 and 24 hours after the procedure. Diagnosis of AKI was,
according to the Kidney Disease; Improving Global Outcomes (KDIGO) criteria (2012).

The mean age in the remote ischemic preconditioning (RIPC) group was 56.8 ± 11.4 years and 56.3 ± 11.8 years in the control group. We observed no significant difference regarding patient’s characteristic and renal biomarkers at baseline. There was no significant difference in the incidence of AKI (P = 0.116). The uNGAL increased by 36.2% 6-hour after the procedure in patients with AKI, while at the same time, this biomarker increased only by 4.3% in patients without AKI.

We concluded that RIPC, with 3 cycles of 5-minute ischemia and 5-minute reperfusion, did not decrease CIN-AKI or altering renal biomarkers course in low-risk patients undergoing coronary angiography or PCI. Additionally, uNGAL, seems to be an appropriate biomarker for early diagnosis of CIN-AKI, 6 hours after contrast media exposure.

This study aimed to show the effects of thymoquinone, which is known for its antioxidant, anti-inflammatory, and renal protective effects in contrast-induced nephropathy.

This is an experimental study in rats. 7 groups were included within the scope of our study: sham-vehicle (n=3), premedication-control (n=6), model (n=6), isolated thymoquinone (n=3+3), low-dose thymoquinone (n=6), and high-dose thymoquinone (n=7). In addition to 48 hr of water deprivation, we pre-medicated the rats with intra-peritoneal indomethacin and L-NAME administration. After premedication, 12.5 ml/kg dose of a high osmolar contrast agent-diatrizoat (Urografin %76) was administrated. Thymoquinone was administrated in two different doses of 1 mg/kg and 1.75 mg/kg for four days intraperitoneally. Renal functions, histopathological differences, oxidative stress parameters, and inflammatory indicators of rats were evaluated at the end of the study.

Significant decreases were observed in levels of serum creatinine and serum BUN with low-dose thymoquinone (1 mg/kg) administration. In light microscopy, significantly less histopathological damage was observed in the low-dose thymoquinone group compared to the contrast agent group. While high-dose thymoquinone is accepted as ineffective biochemically, toxic evidence was identified histopathologically. There were no significant differences between M and TA groups for serum MDA and SOD levels, which were compared to evaluate oxidative stress (P:0.99, P:0.98; respectively). TNF-α, iNOS, and NF-кB gene expressions were not significantly different between all groups (P:0.748, P:0.531, P:0.910; respectively).

This experimental study has demonstrated for the first time the protective effect of the TQ substance for CIN in 1 mg/kg dose, in the accompaniment of biochemical and histopathological data in rats.

Contrast-induced nephropathy (CIN) (known as contrast-induced acute kidney injury) occurs as a result of acute worsening of renal function following a procedure with administration of iodine contrasts agent and remains a substantial concern in clinical practices. The purpose of this study is to investigate the preventive effect of Pentoxifylline supplementation on reduction of CIN occurrence after percutaneous coronary intervention among patients who were high risk of CIN according to Mehran score.In randomized, double-blind clinical trial patients who undergo coronary angiography with Mehran Score ≥ 11 consisted of our population. Patients in a ratio 1:1, divided into two groups received saline 0.9% plus N-acetyl cysteine and Pentoxifylline 400 mg three times per day 24 h before angiography until 48 h after angiography. In control group, the patients received placebo instead of PTX in a same manner as the control group. The endpoint was the incidence of CIN defined as creatinine increase of 0.5 mg/dL within 2 days after contrast.There were no significant differences in baseline characteristics. CIN occurred in 3 (5.5%) and 4 (7.3%) patients of the both groups (Pentoxifylline and control), respectively (p = 0.69; incidence odds ratio 1.36; 95% CI 0.29-6.38). No significant differences were seen in secondary outcome measures and changes in the level of creatinine (p = 0.54).In high-risk patients undergoing coronary angiography pentoxifylline supplementation had protection effect against contrast-induced nephropathy greater than placebo based hydration, but, not supported by our data.

There is some controversy over the efficacy of statins for the prevention of contrastinduced nephropathy (CIN). There have also been reports on varying efficacies of different statins. Hence, in this study the efficacy of atorvastatin and rosuvastatin for the prevention of CIN was assessed. This single-blind randomized clinical trial was performed on 495 random patients with myocardial infarction with ST-segment elevation undergoing primary percutaneous coronary intervention (PCI) in a training referral hospital in 2015. Patients were randomly assigned to receive either atorvastatin 80 mg at admission and daily or rosuvastatin 40 mg at admission and daily. CIN was defined based on serum creatinine elevation after 48 hours from the PCI. The incidence of CIN was observed in 63 patients (21.4%) After 48 hours from primary PCI. Of those, 17% (n = 50) were grade 1 CIN, while 4.4% (n = 13) were grade 2 CIN. There was no significant difference between rosuvastatin group compared with atorvastatin group, regarding the CIN grading (P = 0.14). Our results indicate that atorvastatin and rosuvastatin have similar efficacy for the prevention of CIN.

This study aims to investigate the antioxidant effect of vitamin C in preventing contrast-induced nephropathy (CIN) in diabetic patients after catheterization.

In a double blinded, randomized controlled trial, 90 diabetic patients who were referred for cardiac catheterization were randomly allocated into two arms of vitamin C (A) and placebo (B). The treatment arm (A) received 2 g of vitamin C orally 2 h before catheterization and the control group (B) received 2 g of oral placebo. Six hours before catheterization, patients received fluid resuscitation with normal saline (CIN was considered as a 25% rise in creatinine (Cr) level or an increase of 0.5 mg/dL in earlier creatinine). CIN was compared between groups. Before andthree days after catheterization. Serum Bun – Cr was measured and GFR were calculated. The results were compared between the two groups. Six hours before catheterization, patients received fluid resuscitation with normal saline CIN was compare between arms.

Mean GFR in group (A) before procedure was respectively 69.82±19.26 and after the treatment was 81.51±27.40 (P=0.001). But in group (B) it was 74.18±24.41 and 75.20±29.65 (P=0.747). Contrast-induced nephropathy was observed in 10 patients (12.3%) including 3 patients (7.7%) in group (A) and (16.7%, 7 patients) in group (B) (P=0.315).

Ascorbic acid intake in diabetic patients prior to use of contrast agents can be effective in maintaining GFR, but the incidence of contrast-induced nephropathy is not associated with the consumption of ascorbic acid.

Contrast-induced nephropathy (CIN) is one of the most important complications of angiography in patients with chronic kidney disease (CKD) or diabetes mellitus. The prevention of CIN can decrease therapeutic costs and hospital stays. There is controversy in the literature over the preventive effect of statins on CIN..
This study was designed to evaluate the preventive effect of atorvastatin on CIN after angiography in CKD and diabetic patients..
Patients and In this placebo-controlled, double-blind clinical trial, patients with diabetes mellitus or CKD (15 1.5 mg/dL) and an age range of 55 - 75 years candidated for angiography were included. The patients were randomized to 2 groups: one group receiving atorvastatin (80 mg/d from 48 h before angiography) and the other one receiving a placebo. All the patients received intravenous isotonic saline and N-acetylcysteine. CIN was defined as an increase in serum creatinine more than 0.5 mg/dL or more than 25% from the baseline values..
Totally, 220 patients at a mean age of 63.85 ± 8.89 years and a mean body mass index of 31.41 ± 5.99 kg/m2 were evaluated. In comparison of before-after values, there was a significant increase in serum creatinine in the placebo group (P = 0.000). The incidence of CIN was significantly higher in the control group 24 hours after angiography (P = 0.010); however, at a 48-hour interval, there was no significant difference in CIN between the 2 groups..
Standard hydration and N-acetylcysteine and atorvastatin (80 mg) reduced the incidence of CIN, and this regimen was more effective than was the regimen of hydration and N-acetylcysteine (without atorvastatin) in decreasing CIN. Accordingly, it is reasonable to prescribe atorvastatin before angiography in high-risk patients..

Contrast induced nephropathy (CIN) is one of the most common complications after radiographic procedures using intravascular radiocontrast media. The aim of the current study was to assess the effect of atorvastatin on prevention of CIN in patients undergoing coronary angiography. In a clinical trial study, 200 patients referred for angiography were randomly divided into two groups of using 80 mg atorvastatin and placebo before the procedure. Furthermore, 100 patients who were under chronic treatment of statins were included as the third group. Serum creatinine (Scr) levels before and after the procedure were evaluated and incidence of CIN (post-procedural Scr of >0.5 mg/dl or 25% from baseline) was assessed. Mean age of the participants was 60.06 ± 0.69 years and 276 (92%) were male. There were no significant differences between group with respect to age and gender. In pre-operation atorvastatin, placebo and long term statin groups, the incidence of CIN was 1%, 2% and 1%, and mean changes of Glomerular filtration rate (GFR) was 3.68 ± 1.32, −0.77 ± 1.21 and 1.37 ± 0.86; and mean changes of creatinine (Cr) was −0.05 ± 0.02, 0.02 ± 0.02 and −0.01 ± 0.01 respectively. respectively (P = 0.776, 0.026 and 0.041 respectively). In pre-operation atorvastatin group, Cr decreased, and GFR increased significantly (P = 0.019 and 0.007 respectively). pre-operation short term high dose atorvastatin use was associated with a significant decrease in serum Cr level and increase in GFR after angiography.