Injuria renal aguda asociada a medios de contraste radiológicos yodados: una mirada actualizada
Palabras clave:
medios de contraste, compuestos yodados, riesgo, injuria renal aguda
Resumen
La injuria renal aguda asociada a medios de contraste radiológicos yodados es una entidad clínica cuya real dimensión aún es discutida. La importancia del tipo de medio de contraste y las condiciones predisponentes son discutidas en una revisión actualizada del tema, poniendo énfasis en los factores fisiopatológicos involucrados y las estrategias preventivas más efectivas. Una adecuada valoración clínica permitirá efectuar exámenes complementarios que pueden resultar cruciales para el manejo de los pacientes y evitar el uso de estrategias preventivas innecesarias y potencialmente dañinas.
Citas
1) Mehran R, Dangas GD, Weisbord SD. Contrast-Associated acute kidney injury. N Engl J Med. 2019;380(22):2146-55. doi: 10.1056/NEJMra1805256.
2) Rudnick MR, Leonberg-Yoo AK, Litt HI, Cohen RM, Hilton S, Reese PP. The controversy of contrast-induced nephropathy with intravenous contrast: what is the risk? Am J Kidney Dis. 2020;75(1):105-13. doi: 10.1053/j.ajkd.2019.05.022.
3) Quader MA, Sumpio BE. Radio contrast agents: history and evolution. En: CJB, editor. Text of Angiology. New York, NY: Springer; 2000, p. 775-83.
4) Thomsen HS, Vestergaard A, Nielsen SL, Fogh-Andersen N, Golman K, Dorph S. Renal clearance of an ionic high-osmolar and a nonionic low-osmolar contrast medium. Invest Radiol. 1991;26(6):564-8. doi: 10.1097/00004424-199106000-00011.
5) Lawaczeck R, Jost G, Pietsch H. Pharmacokinetics of contrast media in humans: model with circulation, distribution, and renal excretion. Invest Radiol. 2011;46(9):576-85. doi: 10.1097/RLI.0b013e31821c1140.
6) Beckett KR, Moriarity AK, Langer JM. Safe use of contrast media: what the radiologist needs to know. Radiographics. 2015;35(6):1738-50. doi: 10.1148/rg.2015150033.
7) Munger K, Brenner B, Kost CJ. The renal circulations and glomerular ultrafiltration. En: Skorecki K, Chertow GM, Marsden PA, Brenner BM, Rector FC. Brenner and Rector´s the Kidney. 10th ed. Philadelphia: Elsevier, 2016, pp. 83-111.
8) Jefferson JA, Schrier RW. Pathophysiology and etiology of acute kidney injury. En: Johnson RJ, Feehally J, Floege J. Comprehensive clinical nephrology. 5th ed. Philadelphia: Saunders, Elsevier; 2015, pp. 802-17.
9) Geenen RWF, Kingma HJ, van der Molen AJ. Pathophysiology of contrast-induced acute kidney injury. Interv Cardiol Clin. 2014;3(3):363-7. doi: 10.1016/j.iccl.2014.03.007.
10) Pallone TL, Turner MR, Edwards A, Jamison RL. Countercurrent exchange in the renal medulla. Am J Physiol Regul Integr Comp Physiol. 2003;284(5):R1153-75. doi: 10.1152/ajpregu.00657.2002.
11) Fähling M, Seeliger E, Patzak A, Persson PB. Understanding and preventing contrast-induced acute kidney injury. Nat Rev Nephrol. 2017;13(3):169-80. doi: 10.1038/nrneph.2016.196.
12) Weisbord SD, Palevsky PM. Iodinated contrast media and the role of renal replacement therapy. Adv Chronic Kidney Dis. 2011;18(3):199-206. doi: 10.1053/j.ackd.2010.11.008.
13) Lautin EM, Freeman NJ, Schoenfeld AH, Bakal CW, Haramati N, Friedman AC, et al. Radiocontrast-associated renal dysfunction: incidence and risk factors. AJR Am J Roentgenol. 1991;157(1):49-58. doi: 10.2214/ajr.157.1.2048539.
14) Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393-9. doi: 10.1016/j.jacc.2004.06.068.
15) Bartholomew BA, Harjai KJ, Dukkipati S, Boura JA, Yerkey MW, Glazier S, et al. Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol. 2004;93(12):1515-9. doi: 10.1016/j.amjcard.2004.03.008.
16) Tsai TT, Patel UD, Chang TI, Kennedy KF, Masoudi FA, Matheny ME, et al. Validated contemporary risk model of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the National Cardiovascular Data Registry Cath-PCI Registry. J Am Heart Assoc. 2014;3(6):e001380. doi: 10.1161/JAHA.114.001380.
17) Liu YH, Liu Y, Zhou YL, He PC, Yu DQ, Li LW, et al. Comparison of different Risk scores for predicting contrast induced nephropathy and outcomes after primary percutaneous coronary intervention in patients with ST elevation myocardial infarction. Am J Cardiol. 2016;117(12):1896-903. doi: 10.1016/j.amjcard.2016.03.033.
18) Silver SA, Shah PM, Chertow GM, Harel S, Wald R, Harel Z. Risk prediction models for contrast induced nephropathy: systematic review. BMJ. 2015;351:h5401. doi: 10.1136/bmj.h5401. Erratum for: BMJ. 2015;351:h4395.
19) Wi J, Ko YG, Shin DH, Kim JS, Kim BK, Choi D, et al. Prediction of contrast-induced nephropathy with persistent renal dysfunction and adverse long-term outcomes in patients with acute myocardial infarction using the Mehran risk score. Clin Cardiol. 2013;36(1):46-53. doi: 10.1002/clc.22060.
20) Sato A, Hoshi T, Kakefuda Y, Harunari T, Watabe H, Hiraya D, et al. Effect of the Mehran risk score for the prediction of clinical outcomes after percutaneous coronary intervention. J Cardiol. 2015;66(5):417-22. doi: 10.1016/j.jjcc.2014.12.016.
21) Zungur M, Gul I, Tastan A, Damar E, Tavli T. Predictive value of the Mehran score for contrast-induced nephropathy after transcatheter aortic valve implantation in patients with aortic stenosis. Cardiorenal Med. 2016;6(4):279-88. doi: 10.1159/000443936.
22) Abellás-Sequeiros RA, Raposeiras-Roubín S, Abu-Assi E, González-Salvado V, Iglesias-Álvarez D, Redondo-Diéguez A, et al. Mehran contrast nephropathy risk score: Is it still useful 10 years later? J Cardiol. 2016;67(3):262-7. doi: 10.1016/j.jjcc.2015.05.007.
23) Valappil SP, Kunjukrishnapillai S, Iype M, Koshy AG, Viswanathan S, Gupta PN, et al. Predictors of contrast induced nephropathy and the applicability of the Mehran risk score in high risk patients undergoing coronary angioplasty-A study from a tertiary care center in South India. Indian Heart J. 2018;70(3):399-404. doi: 10.1016/j.ihj.2017.08.018.
24) Sgura FA, Bertelli L, Monopoli D, Leuzzi C, Guerri E, Spartà I, et al. Mehran contrast-induced nephropathy risk score predicts short- and long-term clinical outcomes in patients with ST-elevation-myocardial infarction. Circ Cardiovasc Interv. 2010;3(5):491-8. doi: 10.1161/CIRCINTERVENTIONS.110.955310.
25) Blanco A, Rahim F, Nguyen M, Quach S, Guduru S, Makadia S, et al. Performance of a pre-procedural Mehran score to predict acute kidney injury after percutaneous coronary intervention. Nephrology (Carlton). 2021;26(1):23-9. doi: 10.1111/nep.13769.
26) Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84. doi: 10.1159/000339789.
27) Weisbord SD, Palevsky PM. Contrast-induced acute kidney injury: short- and long-term implications. Semin Nephrol. 2011;31(3):300-9. doi: 10.1016/j.semnephrol.2011.05.009.
28) Pomara C, Pascale N, Maglietta F, Neri M, Riezzo I, Turillazzi E. Use of contrast media in diagnostic imaging: medico-legal considerations. Radiol Med. 2015;120(9):802-9. doi: 10.1007/s11547-015-0549-6.
2) Rudnick MR, Leonberg-Yoo AK, Litt HI, Cohen RM, Hilton S, Reese PP. The controversy of contrast-induced nephropathy with intravenous contrast: what is the risk? Am J Kidney Dis. 2020;75(1):105-13. doi: 10.1053/j.ajkd.2019.05.022.
3) Quader MA, Sumpio BE. Radio contrast agents: history and evolution. En: CJB, editor. Text of Angiology. New York, NY: Springer; 2000, p. 775-83.
4) Thomsen HS, Vestergaard A, Nielsen SL, Fogh-Andersen N, Golman K, Dorph S. Renal clearance of an ionic high-osmolar and a nonionic low-osmolar contrast medium. Invest Radiol. 1991;26(6):564-8. doi: 10.1097/00004424-199106000-00011.
5) Lawaczeck R, Jost G, Pietsch H. Pharmacokinetics of contrast media in humans: model with circulation, distribution, and renal excretion. Invest Radiol. 2011;46(9):576-85. doi: 10.1097/RLI.0b013e31821c1140.
6) Beckett KR, Moriarity AK, Langer JM. Safe use of contrast media: what the radiologist needs to know. Radiographics. 2015;35(6):1738-50. doi: 10.1148/rg.2015150033.
7) Munger K, Brenner B, Kost CJ. The renal circulations and glomerular ultrafiltration. En: Skorecki K, Chertow GM, Marsden PA, Brenner BM, Rector FC. Brenner and Rector´s the Kidney. 10th ed. Philadelphia: Elsevier, 2016, pp. 83-111.
8) Jefferson JA, Schrier RW. Pathophysiology and etiology of acute kidney injury. En: Johnson RJ, Feehally J, Floege J. Comprehensive clinical nephrology. 5th ed. Philadelphia: Saunders, Elsevier; 2015, pp. 802-17.
9) Geenen RWF, Kingma HJ, van der Molen AJ. Pathophysiology of contrast-induced acute kidney injury. Interv Cardiol Clin. 2014;3(3):363-7. doi: 10.1016/j.iccl.2014.03.007.
10) Pallone TL, Turner MR, Edwards A, Jamison RL. Countercurrent exchange in the renal medulla. Am J Physiol Regul Integr Comp Physiol. 2003;284(5):R1153-75. doi: 10.1152/ajpregu.00657.2002.
11) Fähling M, Seeliger E, Patzak A, Persson PB. Understanding and preventing contrast-induced acute kidney injury. Nat Rev Nephrol. 2017;13(3):169-80. doi: 10.1038/nrneph.2016.196.
12) Weisbord SD, Palevsky PM. Iodinated contrast media and the role of renal replacement therapy. Adv Chronic Kidney Dis. 2011;18(3):199-206. doi: 10.1053/j.ackd.2010.11.008.
13) Lautin EM, Freeman NJ, Schoenfeld AH, Bakal CW, Haramati N, Friedman AC, et al. Radiocontrast-associated renal dysfunction: incidence and risk factors. AJR Am J Roentgenol. 1991;157(1):49-58. doi: 10.2214/ajr.157.1.2048539.
14) Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393-9. doi: 10.1016/j.jacc.2004.06.068.
15) Bartholomew BA, Harjai KJ, Dukkipati S, Boura JA, Yerkey MW, Glazier S, et al. Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol. 2004;93(12):1515-9. doi: 10.1016/j.amjcard.2004.03.008.
16) Tsai TT, Patel UD, Chang TI, Kennedy KF, Masoudi FA, Matheny ME, et al. Validated contemporary risk model of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the National Cardiovascular Data Registry Cath-PCI Registry. J Am Heart Assoc. 2014;3(6):e001380. doi: 10.1161/JAHA.114.001380.
17) Liu YH, Liu Y, Zhou YL, He PC, Yu DQ, Li LW, et al. Comparison of different Risk scores for predicting contrast induced nephropathy and outcomes after primary percutaneous coronary intervention in patients with ST elevation myocardial infarction. Am J Cardiol. 2016;117(12):1896-903. doi: 10.1016/j.amjcard.2016.03.033.
18) Silver SA, Shah PM, Chertow GM, Harel S, Wald R, Harel Z. Risk prediction models for contrast induced nephropathy: systematic review. BMJ. 2015;351:h5401. doi: 10.1136/bmj.h5401. Erratum for: BMJ. 2015;351:h4395.
19) Wi J, Ko YG, Shin DH, Kim JS, Kim BK, Choi D, et al. Prediction of contrast-induced nephropathy with persistent renal dysfunction and adverse long-term outcomes in patients with acute myocardial infarction using the Mehran risk score. Clin Cardiol. 2013;36(1):46-53. doi: 10.1002/clc.22060.
20) Sato A, Hoshi T, Kakefuda Y, Harunari T, Watabe H, Hiraya D, et al. Effect of the Mehran risk score for the prediction of clinical outcomes after percutaneous coronary intervention. J Cardiol. 2015;66(5):417-22. doi: 10.1016/j.jjcc.2014.12.016.
21) Zungur M, Gul I, Tastan A, Damar E, Tavli T. Predictive value of the Mehran score for contrast-induced nephropathy after transcatheter aortic valve implantation in patients with aortic stenosis. Cardiorenal Med. 2016;6(4):279-88. doi: 10.1159/000443936.
22) Abellás-Sequeiros RA, Raposeiras-Roubín S, Abu-Assi E, González-Salvado V, Iglesias-Álvarez D, Redondo-Diéguez A, et al. Mehran contrast nephropathy risk score: Is it still useful 10 years later? J Cardiol. 2016;67(3):262-7. doi: 10.1016/j.jjcc.2015.05.007.
23) Valappil SP, Kunjukrishnapillai S, Iype M, Koshy AG, Viswanathan S, Gupta PN, et al. Predictors of contrast induced nephropathy and the applicability of the Mehran risk score in high risk patients undergoing coronary angioplasty-A study from a tertiary care center in South India. Indian Heart J. 2018;70(3):399-404. doi: 10.1016/j.ihj.2017.08.018.
24) Sgura FA, Bertelli L, Monopoli D, Leuzzi C, Guerri E, Spartà I, et al. Mehran contrast-induced nephropathy risk score predicts short- and long-term clinical outcomes in patients with ST-elevation-myocardial infarction. Circ Cardiovasc Interv. 2010;3(5):491-8. doi: 10.1161/CIRCINTERVENTIONS.110.955310.
25) Blanco A, Rahim F, Nguyen M, Quach S, Guduru S, Makadia S, et al. Performance of a pre-procedural Mehran score to predict acute kidney injury after percutaneous coronary intervention. Nephrology (Carlton). 2021;26(1):23-9. doi: 10.1111/nep.13769.
26) Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84. doi: 10.1159/000339789.
27) Weisbord SD, Palevsky PM. Contrast-induced acute kidney injury: short- and long-term implications. Semin Nephrol. 2011;31(3):300-9. doi: 10.1016/j.semnephrol.2011.05.009.
28) Pomara C, Pascale N, Maglietta F, Neri M, Riezzo I, Turillazzi E. Use of contrast media in diagnostic imaging: medico-legal considerations. Radiol Med. 2015;120(9):802-9. doi: 10.1007/s11547-015-0549-6.
Publicado
2021-12-06
Cómo citar
1.
Herrera P, Wenger R, Aros C, Ardiles LG, Muñóz D. Injuria renal aguda asociada a medios de contraste radiológicos yodados: una mirada actualizada. Rev Nefrol Dial Traspl. [Internet]. 6 de diciembre de 2021 [citado 21 de diciembre de 2024];41(4):292-9. Disponible en: http://revistarenal.org.ar/index.php/rndt/article/view/718
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Derechos de autor 2021 Revista de Nefrología, Diálisis y Trasplante
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