造影剂肾病的危险因素及预防

随着造影剂在放射诊断技术和介入诊治技术中的应用日趋广泛,造影剂肾病(CIN)已成为一种不容忽视的医源性肾脏疾病,是院内获得性急性肾衰竭的常见原因,且发病率和病死率逐年增加。造影剂肾病延长患者的住院时间,增加患者的医疗费用,部分患者出现不可逆的肾功损害,存在很高的死亡风险。目前CIN尚无有效的治疗方法,也无绝对有效的措施完全阻止该病的发生,只能通过正确认识其危险因素、辨别高危患者并采取适当的预防措施来降低CIN患病风险,改善患者预后。目前已知的造影剂肾病的危险因素包括已存在肾脏损害、糖尿病、高龄、使用高渗离子型造影剂等,预防措施也有一定的进展,水化、某些药物等均有一定的预防作用。本文主要对造影剂肾病的危险因素及预防措施进行综述。

The Risk Factors and Prevention of Contrast-induced Nephropathy

with the development of interventional radiological procedures, contrast-induced nephropathy (CIN) has been a common serious kidney disease. It is also a common cause of hospital-acquired acute renal failure, and the morbidity and mortality are increasing year by year. Contrast-induced nephropathy not only extend hospitalization time but also increase patients'' medical costs.Some patients with irreversible renal function damage has a high risk of death. Nowadays contrast-induced nephropathy has no specific treatment and no efficient measures to prevent the occurrence of the disease completely. So identifying high-risk patients and taking appropriate preventive measures are the key to reduce this disease and improve the prognosis. Its known risk factors include existing kidney damage, diabetes, advanced age, using high osmotic ionic contrast medium, etc and preventive measures also consist of hydration, certain drugs, etc. The purpose of this report is mainly to review the risk factors and preventive measures of the disease.