Contrast Induced Nephropathy
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Transcript of Contrast Induced Nephropathy
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CONTRAST INDUCED NEPHROPATHYDR SANJEEV V NAIRPG, DEPT OF NEPHROLOGY
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INTRODUCTIONSignificant source of hospital morbidity and mortalityThird most common cause of acute kidney injury; after surgery and hypotension Tublin ME et al. Current concepts in contrast media-induced nephropathy. AJR1998; 171:933-939
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Contrast AgentsIodinated- benzoic acid ring; Either Monomeric or dimericIonic or Non-ionicBased on osmolarity:High Osmolar Contrast Media (HOCM)Low Osmolar Contrast Media (LOCM)Iso-Osmolar Contrast Media (IOCM)
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Contrast AgentsHOCM: Ionic;Diatrizoates/Iothalamates/MetrizoatesHighly hyperosmolar: 1400-1800mOsm/kgLOCM: Non-ionic*; Less Hyperosmolar: 500-850mOsm/kg E.g. Iohexol, Iopamidol, Ioversol *IoxaglateIOCM: Non-ionicOsmolarity: ~290mOsm/kgIotrol and Iodixanol
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Contrast AgentsContrast reactions: Not allergic; No Abs isolated; 5-6% in gen popln; 10-12% in pts with allergy; 15-20% if prev contrast allergyMild-severe. No established determinant: rate/dose of injnGlucocorticoids + H1/H2 blockers
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DefinitionMany and varied