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Cardiology Research and Practice
Volume 2010 (2010), Article ID 649164, 12 pages
http://dx.doi.org/10.4061/2010/649164
Review Article

Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

1Cardiology Section, Department of Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
2MBBS Program, The Aga Khan University, B-4, Al-Qahir Apt., Violet Street, Garden East, Karachi 74550, Pakistan

Received 29 March 2010; Revised 21 July 2010; Accepted 25 August 2010

Academic Editor: Christian Wilhelm Hamm

Copyright © 2010 Sana Shoukat et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Contrast Induced Nephropathy (CIN) is a feared complication of numerous radiological procedures that expose patients to contrast media. The most notorious of these procedures is percutaneous coronary intervention (PCI). Not only is this a leading cause of morbidity and mortality, but it also adds to increased costs in high risk patients undergoing PCI. It is thought to result from direct cytotoxicity and hemodynamic challenge to renal tissue. CIN is defined as an increase in serum creatinine by either 0.5 mg/dL or by 25% from baseline within the first 2-3 days after contrast administration, after other causes of renal impairment have been excluded. The incidence is considerably higher in diabetics, elderly and patients with pre-existing renal disease when compared to the general population. The nephrotoxic potential of various contrast agents must be evaluated completely, with prevention as the mainstay of focus as no effective treatment exists. The purpose of this article is to examine the pathophysiology, risk factors, and clinical course of CIN, as well as the most recent studies dealing with its prevention and potential therapeutic interventions, especially during PCI. The role of gadolinium as an alternative to iodinated contrast is also discussed.