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Kontrastmittel-induzierte Nephropathie

Contrast-induced nephropathy

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Intensivmedizin + Notfallmedizin

Summary

The use of iodinated contrast media (CM) continues to be a common cause of hospital-acquired acute renal failure (ARF) and its development increases the in-hospital mortality significantly. Thus, considerable efforts have been made to develop techniques to prevent acute renal failure, or to facilitate its recovery. Various strategies for the prevention of contrast-induced nephropathy (CN) have been studied, with conflicting results. Most studies used hydration as a basic intervention maneuver. Pharmaceutical interventions included the use of antioxidants, adenosine antagonists, sodium bicarbonate, domapine, prostaglandins, etc. Trials with new radio contrast agents (i. e., iodixanol) or gadolinium-containing agents has been limited to a few patients. The results of these trials will be reviewed by this paper, as well as the use of dialysis in order to treat and prevent contrast damage to the kidney.

Zusammenfassung

Die Anwendung von Röntgenkontrastmitteln ist eine der häufigsten Ursachen einer akuten Verschlechterung der Nierenfunktion im Rahmen eines Krankenhausaufenthaltes. Durch diese so genannte „Kontrastmittelnephropathie“ wird die Mortalität der Patienten deutlich gesteigert. Eine Vielzahl von Präventionsstrategien wurden in den letzten Jahren entwickelt, die hinsichtlich der Studienlage sehr unterschiedliche Resultate ergaben. Die Mehrzahl der Studien hatten eine Hydratation als Basisstrategie. Pharmakologische Interventionen beinhalteten Studien mit Antioxidantien, Bikarbonat, Adenosinantagonisten, Dopamin, Prostaglandine u. a. Der Versuch neue Kontrastmittel einzusetzen ist bisher nur in wenigen Studien erfolgreich. Die Resultate der vorliegenden Studien werden innerhalb dieser Übersicht ausführlich beschrieben und bewertet, einschließlich des Einsatzes der Dialyse im Rahmen der Kontrastmittelgabe.

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  1. St.-Joseph-Krankenhaus, Medizinische Abt. II, Bäumerplan 24, 12101, Berlin, Germany

    C. M. Erley

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Serie: Die Intensivtherapie bei akutem Nierenversagen Herausgegeben von H. Kierdorf (Braunschweig)

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Erley, C.M. Kontrastmittel-induzierte Nephropathie. Intensivmed + Notfallmed 42, 39–46 (2005). https://doi.org/10.1007/s00390-005-0563-3

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