Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention英文文献资料.docVIP

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Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention英文文献资料.doc

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Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention英文文献资料

SAGE-HindawiAccesstoResearch CardiologyResearchandPractice Volume2010,ArticleID649164,12pages doi:10.4061/2010/649164 ReviewArticle Contrast-InducedNephropathyinPatientsUndergoing PercutaneousCoronaryIntervention SanaShoukat, SaqibA.Gowani, AsifJafferani, andSajidH.Dhakam 1 1 2 1 1 2 CardiologySection,DepartmentofMedicine,TheAgaKhanUniversity,StadiumRoad,P.O.Box3500,Karachi74800,Pakistan MBBSProgram,TheAgaKhanUniversity,B-4,Al-QahirApt.,VioletStreet,GardenEast,Karachi74550,Pakistan CorrespondenceshouldbeaddressedtoAsifJa?erani,asifahsanali@yahoo.co.uk Received29March2010;Revised21July2010;Accepted25August2010 AcademicEditor:ChristianWilhelmHamm Copyright?2010SanaShoukatetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Contrast Induced Nephropathy (CIN) is a feared complication of numerous radiological procedures that expose patients to contrastmedia.Themostnotoriousoftheseproceduresispercutaneouscoronaryintervention(PCI).Notonlyisthisaleading causeofmorbidityandmortality,butitalsoaddstoincreasedcostsinhighriskpatientsundergoingPCI.Itisthoughttoresult fromdirectcytotoxicityandhemodynamicchallengetorenaltissue.CINisde?nedasanincreaseinserumcreatininebyeither ≥0.5mg/dLorby≥25%frombaselinewithinthe?rst2-3daysaftercontrastadministration,afterothercausesofrenalimpairment havebeenexcluded.Theincidenceisconsiderablyhigherindiabetics,elderlyandpatientswithpre-existingrenaldiseasewhen comparedtothegeneralpopulation.Thenephrotoxicpotentialofvariouscontrastagentsmustbeevaluatedcompletely,with preventionasthemainstayoffocusasnoe?ectivetreatmentexists.Thepurposeofthisarticleistoexaminethepathophysiology, riskfactors,andclinicalcourseofCIN,aswellasthemostrecentstudiesdealingwithitspreventionandpotentialtherapeutic interventions,especiallyduringPCI.Theroleofgadoliniumasanalternativetoio