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2. Contrast Induced Nephropathy - Background. Radiocontrast DyeIonic AcidEarlier form of dye.High Osmolarities (1500 to 1800 mosmol/kg).Non-Ionic AcidCurrent type of dye.IsoOsmotic (approximately 290 mosmol/kg)UpToDate v13.1: Radiocontrast media-induced acute renal failure . 3. Contrast I
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1. 1 Journal Club 4.26.05M. Danish Neyaz, D.O Prevention of Contrast-Induced Nephropathy With Sodium Bicarbonate.
2. 2 Contrast Induced Nephropathy - Background Radiocontrast Dye
Ionic Acid
Earlier form of dye.
High Osmolarities (1500 to 1800 mosmol/kg).
Non-Ionic Acid
Current type of dye.
IsoOsmotic (approximately 290 mosmol/kg)
UpToDate v13.1: Radiocontrast media-induced acute renal failure
3. 3 Contrast Induced Nephropathy - Background Dye Volume
Diagnostic Cath: 100mL
Interventional Cath: 250 300 mL
Spiral CT Chest: 100 150 mL
Cox et al. Preventing Contrast Nephropathy: What Is the Best Strategy? A Review
of the Literature . The Journal of Clinical Pharmacology, 2004; 44:327-337
4. 4 Contrast Induced Nephropathy - Background Risk Factors related to Contrast Induced Nephropathy (CIN)
Age > 55
Renal Insufficiency
DM
Volume Depletion
Liver Failure
Recent Contrast Exposure
Proteinuria
Multiple Myeloma
Schrier et al., Renal and Electrolyte Disorders p.430
5. 5 Contrast Induced Nephropathy - Background CIN Predisposing Factors
Renal Medullary Hypoxia (1)
Altered Renal Hemodynamics
Reactive Oxygen Species (2)
Prostaglandins/Endothelin/NO synthesis/inhibition
1. Heyman et al., Pathophysiology of Radiocontrast Nephropathy: A Role for
Medullary Hypoxia. Investigative Radiology. 34(11):685, November 1999.
2. Bakris et al., Radiocontrast medium-induced declines in renal function: a role for oxygen
free radicals. Am J. Physiol. 1990 258:F115-120
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