放射线相关急性肾损伤的最新进展。

Q3 Medicine
Baylor University Medical Center Proceedings Pub Date : 2024-08-29 eCollection Date: 2024-01-01 DOI:10.1080/08998280.2024.2395765
Mohammed Mahgoub, Jerry Fan, Luis Concepcion, Stephan B Tanner, Kadilee Adams, Robert J Widmer
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引用次数: 0

摘要

造影剂相关急性肾损伤(CA-AKI)是指近期接触碘化放射造影剂后,肾功能突然下降。CA-AKI 表现为血清肌酐水平升高或尿量减少。CA-AKI 是住院患者 AKI 的第三大主要原因。CA-AKI的发生率因患者人群特征而异,在普通人群中为5%,而在已有糖尿病、心血管疾病和慢性肾病等合并症的特殊人群中则高达30%。CA-AKI 的发生会增加患者的发病率、死亡率、住院时间、再入院风险和医疗费用,给患者和医疗系统带来沉重的负担。接受心导管检查的患者尤其值得关注,因为他们发生 CA-AKI 及其相关并发症的风险较高。过去几年中,随着液体管理指南、使用肾毒性较低的放射造影剂和术前 CA-AKI 风险评估的引入,CA-AKI 的识别、预防和管理得到了改善。未来在患者 CA-AKI 风险分层和早期检测方面的进步将有助于及时启动缓解治疗计划并减少相关并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current updates in radiocontrast-associated acute kidney injury.

Contrast-associated acute kidney injury (CA-AKI) is an abrupt decline in kidney function occurring after a recent exposure to iodinated radiocontrast media. CA-AKI presents as elevated serum creatinine level or decreased urine output. CA-AKI is the third leading cause of inpatient AKI. The incidence of CA-AKI varies according to patient population characteristics, ranging from 5% in the general population to as high as 30% in special populations with preexisting comorbidities such as diabetes mellitus, cardiovascular disease, and chronic kidney disease. The development of CA-AKI places a heavy toll on patients and the healthcare system secondary to increased patient morbidity, mortality, hospital length of stay, readmission risk, and healthcare cost. Patients undergoing cardiac catheterization are of special interest, since they have higher risk of developing CA-AKI and its associated complications. The recognition, prevention, and management of CA-AKI has improved over the past few years with the introduction of fluid management guidelines, using less nephrotoxic radiocontrast media, and preprocedural CA-AKI risk assessment. Future advancements in patients' CA-AKI risk stratification and early detection will facilitate prompt initiation of mitigation treatment plans and decrease associated complications.

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CiteScore
1.30
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