The Present and Future
Review Topic of the Week
Contrast-Induced Acute Kidney Injury

https://doi.org/10.1016/j.jacc.2016.05.099Get rights and content
open access

Abstract

Coronary angiography and percutaneous intervention rely on the use of iodinated intravascular contrast for vessel and chamber imaging. Despite advancements in imaging and interventional techniques, iodinated contrast continues to pose a risk of contrast-induced acute kidney injury (CI-AKI) for a subgroup of patients at risk for this complication. There has been a consistent and graded signal of risk for associated outcomes including need for renal replacement therapy, rehospitalization, and death, according to the incidence and severity of CI-AKI. This paper reviews the epidemiology, pathophysiology, prognosis, and management of CI-AKI as it applies to the cardiac catheterization laboratory.

Key Words

cardiac catheterization
coronary angiography
iodine
percutaneous coronary intervention

Abbreviations and Acronyms

ACEI
angiotensin-enzyme inhibitor
ACS
acute coronary syndromes
AKI-D
acute kidney injury requiring dialysis
ARB
angiotensin-receptor blocker
CI
confidence interval
CI-AKI
contrast-induced acute kidney injury
CKD
chronic kidney disease
Cr
creatinine
eGFR
estimated glomerular filtration rate
ESRD
end-stage renal disease
HF
heart failure
HR
hazard ratio
LVEDP
left ventricular end-diastolic pressure
MI
myocardial infarction
PCI
percutaneous coronary intervention
RASi
renin-angiotensin system inhibitors
sCr
serum creatinine
STEMI
ST-segment elevation myocardial infarction
TAVR
transcatheter aortic valve replacement

Cited by (0)

Dr. Stoler is on the advisory boards of Boston Scientific and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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