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Kidney Disease in the Cardiac Catheterization Laboratory pp 209–223Cite as

Pathophysiology of Contrast Induced Acute Kidney Injury

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Abstract

This chapter focuses on the pathophysiology of iodinated intravascular contrast-induced acute kidney injury (CI-AKI). While there is no conclusive evidence of the exact mechanisms involved in CI-AKI, the current understanding of its pathophysiology is summarized in this chapter. First, we provide an overview of the basic anatomy and function of the kidney relevant to the pathophysiology of CI-AKI. We then discuss the key contributory factors in the pathophysiology of CI-AKI including medullary hypoxia, reactive oxygen species, and direct tubular toxicity of contrast. Finally, the unique characteristics of contrast and contributing patient characteristics that are associated with increased risk of nephrotoxicity will be discussed.

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Author information

Authors and Affiliations

  1. Good Samaritan Medical Center, Department of Medicine, Brockton, MA, USA

    Hector M. Madariaga

  2. University of Maryland Medical Center, Department of Medicine, Baltimore, MD, USA

    Tapati Stalam

  3. University of Maryland School of Medicine, Department of Medicine, Division of Nephrology, Baltimore, MD, USA

    Ami M. Patel

  4. MedStar Georgetown University Hospital, Washington, DC, USA

    Beje Thomas

Authors
  1. Hector M. Madariaga
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  2. Tapati Stalam
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  3. Ami M. Patel
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  4. Beje Thomas
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Corresponding author

Correspondence to Beje Thomas .

Editor information

Editors and Affiliations

  1. Einstein Medical Center/Thomas Jefferson University, Department of Medicine/Nephrology, Philadelphia, PA, USA

    Janani Rangaswami

  2. UIC/Advocate Christ Medical Center, Department of Medicine, Chicago, Il, USA

    Edgar V. Lerma

  3. Baylor University Medical Center, Baylor Heart and Vascular Hospital, Department of Internal Medicine, Texas A & M College of Medicine, Division of Cardiology, Dallas, TX, USA

    Peter A. McCullough

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Madariaga, H.M., Stalam, T., Patel, A.M., Thomas, B. (2020). Pathophysiology of Contrast Induced Acute Kidney Injury. In: Rangaswami, J., Lerma, E., McCullough, P. (eds) Kidney Disease in the Cardiac Catheterization Laboratory . Springer, Cham. https://doi.org/10.1007/978-3-030-45414-2_12

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  • DOI: https://doi.org/10.1007/978-3-030-45414-2_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45413-5

  • Online ISBN: 978-3-030-45414-2

  • eBook Packages: MedicineMedicine (R0)

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