Your SlideShare is downloading. ×
0
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Contrast Induced Nephropathy
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Contrast Induced Nephropathy

184

Published on

Published in: Education, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
184
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
9
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. CONTRAST INDUCED NEPHROPATHY
  • 2.  Contrast Induced Nephropathy (CIN) is a recognized complication in diagnostic and intervention procedures and is associated with prolonged hospitalization and adverse clinical outcome.  CIN defined as ….  CIN was reported to the third most common of acute renal failure in hospitalization
  • 3. Risk Factor  Impaired kidney function  Impaired LVEF, heart failure  DM  Dehidration/ volume depletion  Cirrhosis/ nephrosis  NSAID
  • 4. Prognosis  CIN is ussually transient, with serum creatinine levels is peaking at 3 days after administration of the contrast medium and returning to base line within 10 days after administration  Apreciable nephropathy ia unlikely to develop if the serum creatinine levels doesnot increased by more than 0.5 mg/dL within 24 hours
  • 5. Strategies and Evidence  Evaluation of Risk The first step in deriying strategies minimize the inciden CIN is corectlyidentify those individual at greatest risk and review the indication for the administration of Contrast Medium (CM) Measurement of the serum creatinine levels should be made before intra arterial use of the CM and in patient with a history of kidney disease, proteinuria, kidney surgery, hypertension, DM
  • 6. Con’t If CM has to be given, serum creatinine levels should be measured 24-48 hours after administration of the CM
  • 7. Prevention  Protocol of administration fluid The administration of fluid recommended to reduce the risk of CM IV fluid need to be started 1 hours before CM exposure and for minimum 6 hours post CM
  • 8. Con’t  N-Acetylcysteine (NAC) NAC has the potential to reduce the nephrotoxicity of CM throught antioxidant and vasodilatory effect The potent antioxidant NAC may prevent acute renal dysfunction in patient with Chronic Kidney Disease who are undergoing procedures requiring the use of CM
  • 9. Con’t  Vasodilators Trials employing vasodilator have produced negative results In some trials, vasodilators induced systemic hypotension may have contributed to a post procedure rise in serum creatinine levels unrelated to Cm exposure
  • 10. Choice of CM CM can be classified by osmolality 1. High-osmolar CM : sodium diatrizoate 2. Low-osmolar CM : iohexol 3. Iso-osmolar CM : iodoxanol
  • 11. Con’t  In a meta analysis of comparative trials in increase serum creatinine levels of more than 0.5 mg/dL after administration of CM in patient with reduced kidney function was less frequent with low-osmolar than with high-osmolar  Iso-osmolar Cm have been proposed as an alternative. One randomized trials involving patient with DM who have renal impairement should a significantly lower frequently of increase in serum creatinine levels of at least 0.5 mg/dLwith the iso- osmolar.

×