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SüleymanDemirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 2005 Eylül; 12(3) Kontrast madde nefropatisi Gürkan Acar, Selahaddin Akçay, Süleyman Murat Aslan, Mert Köroğlu, Orhan Oyar Özet Kontrast madde nefropatisi (KMN), iyotlu kontrast maddelerin tanısal ve tedavi amaçlı kullanımının artmasıyla birlikte, hastane içinde meydana gelen akut böbrek yetersizliğinin önemli nedenlerinden birisi haline gelmiştir. KMN, hastanın mortalite ve morbiditesini, hastanede kalış süresini ve maliyetini arttırır. Klinik olarak KMN, kontrast madde verdikten sonra böbrek fonksiyonlarındaki akut azalma olarak tanımlanır. Renal medullar hipoksi ve iyotlu kontrast maddelerin renal tübülüsler üzerine olan doğrudan toksik etkisi KMN patofizyolojisinde suçlanan mekanizmalardır. KMN gelişmesi beraberindeki risk faktörlerinin sayısı ile doğrudan ilişkilidir. KMN için tanımlanan pek çok risk faktörü arasındaönemlileri, önceden var olan böbrek yetersizliği, diyabet ve kullanılan kontrast madde miktarıdır. KMN insidansını azaltacaketkili yöntem, kontrast madde vermeden önce risk faktörlerini tanımlayarak önlem almaktır. Bu derlemede, KMN'nin risk faktörleri ve patofizyolojisi tartışılmış ve iyotlu kontrast maddelerin bazı özellikleri özetlenmiştir. Anahtar kelimeler: Kontrast madde nefropatisi, Kontrast maddeler, Risk faktörleri, Patofizyoloji Abstract Radiocontrast-induced nephropathy Radiocontrast-induced nephropathy (CIN) is currently a major cause of hospital-acquired acute renal failure, because of increasing usage of these agents in both diagnostic and interventional procedures. CIN leads to undesirable clinical circumstances which may result in dead as well as increasing length of hospitalisation and high costs. CIN is clinically defined as a sudden decline in renal functions after contrast media administration. The proposed pathophysiologic mechanisms of CIN are renal medullar hypoxia and direct tubuler toxicity of radiocontrast medium. The occurence of CIN is directly related to the number of coexisting clinical risk factors. Some of described risk factors for the developing of CIN are preexisting renal insufficiency, presence of diabetes mellitus and amount of used contrast agent. It is considered that the most effective management at reducing of the incidence of CIN is detection of risk factors mentioned above before administration of contrast medium. In this review we discussed the risk factors and the pathophysiologic mechanisms of CIN, and summarized some of the properties of contrast media. Key words: Radiocontrast-induced nephropathy, Contrast media, Risk factors, Pathophysiology
SuleymanDemirel University TIP FACULTY JOURNAL: September 2005; 12(3) Contrast substance nefropathy Gürkan Acar, Selahaddin Akçay, Suleyman Murat Aslan, Mert Köroğlu, Orhan Oyar Summary Contrast substance nefropathy (KMN), with the increase in the use of iodine contrast substances for diagnostic and therapeutic purposes, has become one of the major causes of acute kidney failure occurring in the hospital. KMN increases the mortality and morbidity of the patient, the duration and cost of stay in the hospital. Clinically, KMN is defined as an acute decrease in kidney functions after giving the contrast substance. Renal medules are the mechanisms accused of the pathophysology of the direct toxic effect of hypoxic and iodine contrast substances on the renal tubules. The development of KMN is directly related to the number of risk factors associated. Many of the risk factors defined for KMN include preexisting renal insufficiency, diabetes and the quantity of the used contrast substance. The effective method to reduce the incidence of KMN is to take measures by identifying risk factors before giving the contrast substance. In this collection, the risk factors and patophysiology of KMN were discussed and some characteristics of iodine contrast substances were summarized. Keywords: Contrast substance nefropathy, Contrast substances, Risk factors, Patofysiology Abstract Radiocontrast-induced nephropathy Radiocontrast-induced nephropathy (CIN) is currently a major cause of hospital-acquired acute renal failure, because of increasing use of these agents in both diagnostic and interventional procedures. CIN leads to unwanted clinical circumstances which may result in dead as well as increasing length of hospitalization and high costs. CIN is clinically defined as a water decline in renal functions after contrast media administration. The proposed pathophysiological mechanisms of CIN are renal medules hypoxia and direct tubular toxicity of radiocontrast medium. The occurrence of CIN is directly related to the number of coexisting clinical risk factors. Some of described risk factors for the development of CIN are preexisting renal insufficiency, the presence of diabetes mellitus and the amount of used contrast agent. It is considered that the most effective management at reducing the incidence of CIN is detection of risk factors mentioned above before administration of contrast medium. In this review we discussed the risk factors and the pathophysiological mechanisms of CIN, and summarized some of the properties of contrast media. Key words: Radiocontrast-induced nephropathy, Contrast media, Risk factors, Pathophysiology
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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