BOOK
Renal Complications in the Catheterization Laboratory, An Issue of Interventional Cardiology Clinics, E-Book
(2014)
Additional Information
Book Details
Abstract
Interventional cardiologists are able to perform minimally invasive procedures, such as angioplasty and stenting, due to imaging technologies that allow them to see inside the heart and blood vessels without open surgery. Such imaging often requires injection of contrast media, which are generally safe, but for some patients with drug sensitivities or compromised kidney function, contrast-induced nephropathy (CIN) can result. CIN is a major complication that can increase in-hospital mortality. This issue of Interventional Cardiology Clinica addresses the management, treatment, and prevention of renal complications in the catheterization laboratory.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Renal Complications in the Catheterization Laboratory\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Interventional Cardiology Clinics\r | xi | ||
| Preface\r | xiii | ||
| Implications of Kidney Disease in the Cardiac Patient | 317 | ||
| Key points | 317 | ||
| Introduction | 317 | ||
| Coronary artery disease | 318 | ||
| Difficulties in Diagnosis of Acute Coronary Syndrome | 319 | ||
| Medical Management of CAD in Patients with CKD | 319 | ||
| Implications of CKD and percutaneous coronary intervention | 320 | ||
| Implication of CKD and coronary artery bypass surgery | 320 | ||
| Atrial fibrillation | 321 | ||
| Impact of CKD on AF Management | 321 | ||
| Impact of CKD on Anticoagulation | 322 | ||
| Chronic heart failure | 322 | ||
| Medical Management of CHF in Patients with CKD | 323 | ||
| Management of Anemia | 324 | ||
| Device Therapy | 324 | ||
| Summary | 326 | ||
| References | 326 | ||
| Contrast Media | 333 | ||
| Key points | 333 | ||
| Introduction | 333 | ||
| Classification of contrast agents | 333 | ||
| History of imaging | 334 | ||
| Development of iodine-based contrast media | 335 | ||
| Beginnings of angiography | 335 | ||
| Development of HOCM | 335 | ||
| Development of contrast media with a better safety profile | 336 | ||
| Development of LOCM | 337 | ||
| Development of IOCM | 338 | ||
| Viscosity | 338 | ||
| Summary | 339 | ||
| References | 339 | ||
| Nonrenal Complications of Contrast Media | 341 | ||
| Key points | 341 | ||
| Chemotoxic reactions | 342 | ||
| Acute and early anaphylactoid reactions | 342 | ||
| Manifestations and Incidence | 342 | ||
| Pathophysiology | 343 | ||
| Laboratory Testing | 343 | ||
| Treatment of acute anaphylactoid reactions | 343 | ||
| Delayed reactions | 345 | ||
| Prevention of contrast reactions | 346 | ||
| Identifying the Susceptible Patient | 346 | ||
| Pharmacologic Preventive Regimens | 346 | ||
| References | 347 | ||
| Relative Nephrotoxicity of Different Contrast Media | 349 | ||
| Key points | 349 | ||
| Introduction | 349 | ||
| Types of contrast media | 349 | ||
| Role of osmolality in the pathogenesis of CIN | 350 | ||
| HOCM versus LOCM | 351 | ||
| LOCM versus IOCM | 351 | ||
| Intra-arterial studies: comparing the IOCM iodixanol with different LOCM | 352 | ||
| Intravenous studies: comparing the IOCM iodixanol with different LOCM | 352 | ||
| Comparison of CIN incidence between different LOCM and IOCM | 353 | ||
| Current practice and guidelines | 353 | ||
| References | 355 | ||
| Contrast-Induced Nephropathy | 357 | ||
| Key points | 357 | ||
| Introduction | 357 | ||
| Epidemiology and risk prediction | 358 | ||
| Association with adverse events | 359 | ||
| Novel biomarkers and subclinical acute kidney injury | 359 | ||
| Summary | 361 | ||
| References | 361 | ||
| Pathophysiology of Contrast-Induced Acute Kidney Injury | 363 | ||
| Key points | 363 | ||
| Introduction | 363 | ||
| Direct CM molecule tubular cell toxicity | 363 | ||
| Oxygen free radicals | 364 | ||
| Hemodynamic effects | 364 | ||
| Recent developments | 366 | ||
| Summary | 367 | ||
| References | 367 | ||
| Predicting Contrast-induced Renal Complications in the Catheterization Laboratory | 369 | ||
| Key points | 369 | ||
| Introduction | 369 | ||
| Major risk factors for renal complications post-PCI | 370 | ||
| Pre-existing Chronic Kidney Disease | 370 | ||
| Diabetes Mellitus | 370 | ||
| High Contrast Dose | 370 | ||
| Hemodynamic Instability | 370 | ||
| Prediction rules for renal complications post-PCI | 371 | ||
| Prediction of Acute Kidney Injury Post-PCI | 371 | ||
| Prediction of New-Onset Dialysis Post-PCI | 371 | ||
| External validation and comparison of the different risk scores | 371 | ||
| Summary | 376 | ||
| References | 376 | ||
| Biomarkers of Contrast-Induced Nephropathy | 379 | ||
| Key points | 379 | ||
| Introduction | 379 | ||
| Radiocontrast Media | 380 | ||
| Markers of Kidney Injury | 380 | ||
| Traditional markers | 380 | ||
| Potential early markers | 380 | ||
| Markers of kidney injury | 381 | ||
| Neutrophil Gelatinase-Associated Lipocalin | 381 | ||
| Interleukin-18 (Interferon-γ–Inducing Factor) | 383 | ||
| Kidney Injury Molecule 1 | 383 | ||
| Liver-Type Fatty Acid Binding Proteins | 384 | ||
| Urinary N-Acetyl-β-Glucosaminidase | 384 | ||
| Urinary Insulin-Like Growth Factor-Binding Protein 7 and Tissue Inhibitor of Metalloproteinases 2 | 384 | ||
| Midkine | 384 | ||
| Hepcidin | 385 | ||
| Cystatin C, a Marker of Glomerular Filtration | 385 | ||
| Contrast-induced nephropathy after PCI: studies on biomarkers | 385 | ||
| Biomarkers of CIN: which ones, and what is their clinical relevance? | 387 | ||
| References | 388 | ||
| Intravenous and Oral Hydration | 393 | ||
| Key points | 393 | ||
| Introduction | 393 | ||
| Terms | 393 | ||
| Pathophysiology of CM nephrotoxicity | 394 | ||
| Rationale for fluid administration | 394 | ||
| Decrease in Urine CM Concentration | 394 | ||
| Decrease in Urine Viscosity | 395 | ||
| Decrease in Renal Vasoconstrictive Factors | 395 | ||
| Increase in Antioxidant Mechanisms | 395 | ||
| Decrease in O2 Consumption | 395 | ||
| Decrease in Intravascular Contrast Concentration | 395 | ||
| Summary | 396 | ||
| Clinical trials | 396 | ||
| Fluid Versus No Fluid | 396 | ||
| Oral Versus IV | 396 | ||
| IV Fluid for Hours Versus Bolus Immediately Before CM Exposure | 396 | ||
| Hypotonic Versus Isotonic IV Fluid | 397 | ||
| Forced Diuresis with Furosemide or Mannitol | 397 | ||
| Interim Summary | 397 | ||
| Sodium Chloride Versus Sodium Bicarbonate | 397 | ||
| Forced Diuresis with Volume Matching | 402 | ||
| Summary | 402 | ||
| References | 402 | ||
| Pharmacologic Prophylaxis for Contrast-Induced Acute Kidney Injury | 405 | ||
| Key points | 405 | ||
| Introduction | 405 | ||
| Drugs Studied for CI-AKI Prevention | 405 | ||
| Statins | 406 | ||
| Do Statins Reduce CI-AKI Occurrence? | 406 | ||
| Chronic statin treatment and CI-AKI occurrence | 406 | ||
| High-dose statin pretreatment and CI-AKI prevention | 406 | ||
| Short-term high-dose statin pretreatment and CI-AKI prevention | 409 | ||
| Can Statins Improve Prognosis? | 409 | ||
| Conclusions Regarding Statins | 410 | ||
| NAC and CI-AKI | 410 | ||
| Does NAC Reduce CI-AKI Occurrence? | 410 | ||
| Does NAC Improve Prognosis? | 414 | ||
| Ascorbic acid and CI-AKI | 414 | ||
| Does Ascorbic Acid Reduce CI-AKI Occurrence? | 414 | ||
| Does Ascorbic Acid Improve Prognosis? | 415 | ||
| Summary | 415 | ||
| References | 415 | ||
| Device-Based Therapy in the Prevention of Contrast-Induced Nephropathy | 421 | ||
| Key points | 421 | ||
| Introduction | 421 | ||
| Reducing Radiographic Contrast Volumes | 422 | ||
| Removal of contrast media | 422 | ||
| HD and Continuous Veno-Veno Hemofiltration | 424 | ||
| Removal of Contrast via the CS | 424 | ||
| Device-mediated renal protection | 425 | ||
| Automated Balanced Hydration | 425 | ||
| Renal Cooling | 425 | ||
| Intrarenal Drug Infusion | 426 | ||
| Remote Ischemic Conditioning | 426 | ||
| Summary | 426 | ||
| References | 426 | ||
| A Practical Approach to Preventing Renal Complications in the Catheterization Laboratory | 429 | ||
| Key points | 429 | ||
| Background | 429 | ||
| Mechanism and clinical manifestations | 430 | ||
| Risk factors and prediction models | 430 | ||
| Contrast media | 431 | ||
| Prevention strategies | 432 | ||
| Timing of treatment | 434 | ||
| Practical considerations | 434 | ||
| Summary | 436 | ||
| References | 436 | ||
| Renal Complications in Patients Undergoing Peripheral Artery Interventions | 441 | ||
| Key points | 441 | ||
| Contrast-induced nephropathy | 441 | ||
| Incidence | 441 | ||
| Impact of CIN | 442 | ||
| Pathophysiology | 442 | ||
| Risk Factors for CIN | 442 | ||
| Clinical Course | 443 | ||
| Diagnosis | 443 | ||
| Contrast agents | 443 | ||
| Prevention and management of CIN | 443 | ||
| Hydration | 443 | ||
| Pharmacologic-Based and Device-Based Prevention | 444 | ||
| Limiting Contrast Volume | 444 | ||
| Complications during renal artery intervention | 444 | ||
| Atheroembolization | 445 | ||
| Renal Artery Dissection | 445 | ||
| Renal Artery Perforation | 445 | ||
| Renal Artery Thrombosis and Occlusion | 445 | ||
| Renal Infarction | 445 | ||
| Renal complications during endovascular aortic interventions | 445 | ||
| References | 446 | ||
| Renal Complications in Patients Undergoing Transcatheter Aortic Valve Replacement | 449 | ||
| Key points | 449 | ||
| Introduction | 449 | ||
| Incidence | 449 | ||
| Predictors | 450 | ||
| Pre-existing Renal Dysfunction | 450 | ||
| Peripheral Vascular Disease | 451 | ||
| Transapical Approach | 451 | ||
| Periprocedural Bleeding and Blood Transfusion | 451 | ||
| Logistic EuroSCORE | 451 | ||
| Diabetes | 451 | ||
| Other Risk Factors | 451 | ||
| Outcomes | 451 | ||
| Mortality | 451 | ||
| Cost and Length of Stay in Hospital | 451 | ||
| Avoidance and management strategies | 451 | ||
| Pigtail Computed Tomography | 451 | ||
| Transthoracic and Transesophageal Echocardiogram | 452 | ||
| Cardiac Magnetic Resonance | 452 | ||
| Minimize Periprocedural Hypotension | 452 | ||
| Contrast-Induced AKI Precautions | 452 | ||
| Summary | 453 | ||
| References | 453 | ||
| Index | 455 |