Контраст-асоційоване гостре пошкодження нирок: клінічні рекомендації Української асоціації нефрологів і фахівців з трансплантації нирки

M.  Kolesnyk; M.  Kostylev; N.  Stepanova; I.  Shifris; R.  Zatsarynny

doi:10.31450/ukrjnd.4(84).2024.01

M. Kolesnyk Ukrainian Association of Nephrologists and Kidney Transplant Specialists https://orcid.org/0000-0001-6658-3729
M. Kostylev Ukrainian Association of Nephrologists and Kidney Transplant Specialists https://orcid.org/0000-0002-2559-4058
N. Stepanova Ukrainian Association of Nephrologists and Kidney Transplant Specialists https://orcid.org/0000-0002-1070-3602
I. Shifris Ukrainian Association of Nephrologists and Kidney Transplant Specialists https://orcid.org/0000-0002-9413-7301
R. Zatsarynny Ukrainian Association of Nephrologists and Kidney Transplant Specialists

DOI: https://doi.org/10.31450/ukrjnd.4(84).2024.01

Keywords: iodinated contrast media, contrast-associated acute kidney injury, diagnosis, treatment, prevention.

Abstract

Iodinated contrast media (ICM) are among the most commonly used medicinal products in clinical practice for diagnostic or interventional purposes. Acute kidney injury (AKI) that occurs after intravascular administration of ICM is a potentially life-threatening condition and is directly associated with an increased risk of long-term mortality. In Ukraine, there is an urgent need to inform the broader medical community about significant changes in the paradigm surrounding the intravascular use of ICM in clinical practice. In this context, the Ukrainian Association of Nephrologists and Kidney Transplant Specialists working group has developed these guidelines for the prevention, diagnosis, and treatment of contrast-associated AKI.

Downloads

Download data is not yet available.

References

ACR Manual on Contrast Media 2024 ACR Committee on Drugs and Contrast Media. Copyright 2024 American College of Radiology. [Internet]. 2024;117. Available from: https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf.

McDonald JS, McDonald RJ, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Risk of intravenous contrast material-mediated acute kidney injury: a propensity score-matched study stratified by baseline-estimated glomerular filtration rate. Radiology. 2014;271:65-73. doi: 10.1148/radiol.13130775.

Davenport MS, Perazella MA, Yee J, Dillman JR, Fine D, McDonald RJ, et al. Use of Intravenous Iodinated Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2020;294:660-668. doi: 10.1148/radiol.2019192094.

Rudnick MR, Leonberg-Yoo AK, Litt HI, Cohen RM, Hilton S, Reese PP. The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk? Am J Kidney Dis. 2020;75:105-113. doi: 10.1053/j.ajkd.2019.05.022.

ACR Committee on Drugs Contrast Media. ACR Manual on Contrast Media. 10.3. American College of Radiology. [Internet]. 2021. Available from: https://www.radiologyofindiana.com/wp-content/uploads/2021/07/ACR-Manual-on-Contrast-Media-2021.pdf.

Owen RJ, Hiremath S, Myers A, Fraser-Hill M, Barrett BJ. Canadian Association of Radiologists consensus guidelines for the prevention of contrast-induced nephropathy: update 2012. Can Assoc Radiol J. 2014;65:96-105. doi: 10.1016/j.carj.2012.11.002.

Chertow GM, Normand S-LT, McNeil BJ. "Renalism": Inappropriately Low Rates of Coronary Angiography in Elderly Individuals with Renal Insufficiency. J Am Soc Nephrol. 2004;15:2462-2468. doi: 10.1097/01.ASN.0000135969.33773.0B.

Reinecke H, Fobker M, Wellmann J, Becke B, Fleiter J, Heitmeyer C, et al. A randomized controlled trial comparing hydration therapy to additional hemodialysis or N-acetylcysteine for the prevention of contrast medium-induced nephropathy. Clin Res Cardiol. 2007;96:130-139. doi: 10.1007/s00392-007-0473-4.

Wilhelm-Leen E, Montez-Rath ME, Chertow G. Estimating the Risk of Radiocontrast-Associated Nephropathy. J Am Soc Nephrol. 2017;28:653-659. doi: 10.1681/ASN.2016010021.

Brinjikji W, Demchuk AM, Murad MH, Rabinstein AA, McDonald RJ, McDonald JS, et al. Neurons Over Nephrons. Stroke. 2017;48:1862-1868. doi: 10.1161/STROKEAHA.117.016771.

Caspi O, Habib M, Cohen Y, Kerner A, Roguin A, Abergel E, et al. Acute Kidney Injury After Primary Angioplasty: Is Contrast‐Induced Nephropathy the Culprit? J Am Heart Assoc. 2017;6 (6):e005715. doi: 10.1161/JAHA.117.005715.

Neilipovitz J, Rosenberg H, Hiremath S, Savage DW, Ohle R, Alaref A, et al. CJEM Debate Series: contrast-enhanced imaging should not be withheld for emergency department patients as contrast-induced acute kidney injury is very uncommon. Can J Emerg Med. 2021;23:432-436. doi: 10.1007/s43678-021-00126-7.

Kidney Disease Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guidelines for Acute Kidney Injury. Kidney Int Rep. 2012; 2:1-138. doi:10.1038/kisup.2012.6.

Kolesnyk M, Stepanova N, Krasyuk E, Liksunova L, Semenyuk R, Kostinenko T. Prevention, diagnosis and management of acute kidney injury: Adapted clinical guidelines of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists. Ukr J Nephr Dial. 2021;1(69):6-15. doi: 10.31450/ukrjnd.1(69).2021.02.

Newhouse JH, Kho D, Rao QA, Starren J. Frequency of serum creatinine changes in the absence of iodinated contrast material: implications for studies of contrast nephrotoxicity. Am J Roentgenol. 2008;191:376-382. doi: 10.2214/AJR.07.3280.

Trivedi H, Foley WD. Contrast-induced nephropathy after a second contrast exposure. Ren Fail. 2010;32:796-801. doi: 10.3109/0886022X.2010.495441.

Abujudeh HH, Gee MS, Kaewlai R. In Emergency Situations, Should Serum Creatinine Be Checked in All Patients Before Performing Second Contrast CT Examinations Within 24 Hours? J Am Coll Radiol. 2009;6:268-273. doi: 10.1016/j.jacr.2008.09.014.

Thomsen HS, Morcos SK, Barrett BJ. Contrast-induced nephropathy: the wheel has turned 360 degrees. Acta radiologica. 2008;49:646-657. doi: 10.1080/02841850801995413.

Schönenberger E, Martus P, Bosserdt M, Zimmermann E, Tauber R, Laule M, et al. Kidney Injury after Intravenous versus Intra-arterial Contrast Agent in Patients Suspected of Having Coronary Artery Disease: A Randomized Trial. Radiology. 2019;292:664-672. doi: 10.1148/radiol.2019182220.

Nijssen EC, Rennenberg RJ, Nelemans PJ, Essers BA, Janssen MM, Vermeeren MA, et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Lancet. 2017;389:1312-1322. doi: 10.1016/S0140-6736(17)30057-0.

Timal RJ, Kooiman J, Sijpkens YWJ, de Vries JPM, Verberk-Jonkers IJAM, Brulez HFH,et al. Effect of no prehydration vs sodium bicarbonate prehydration prior to contrast-enhanced computed tomography in the prevention of postcontrast acute kidney injury in adults with chronic kidney disease. JAMA Intern Med. 2020;180 (4):533-541. doi: 10.1001/jamainternmed.2019.7428.

Hiremath S, Akbari A, Shabana W, Fergusson DA, Knoll GA. Prevention of contrast-induced acute kidney injury: is simple oral hydration similar to intravenous? A systematic review of the evidence. PLoS One. 2013;8:e60009. doi: 10.1371/journal.pone.0060009.

Weisbord SD, Gallagher M, Jneid H, Garcia S, Cass A, Thwin SS, et al. Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine. N Engl J Med. 2018;378:603-614. doi: 10.1056/NEJMoa1710933.

Huang JW, Lahey B, Clarkin OJ, Kong J, Clark E, Kanji S, et al. A systematic review of the effect of N-Acetylcysteine on serum creatinine and cystatin C measurements. Kidney International Reports. 2021;6(2):396-403. doi: 10.1016/j.ekir.2020.11.018.

Merten GJ, Burgess WP, Gray LV, Holleman JH, Roush TS, Kowalchuk GJ, et al. Prevention of Contrast-Induced Nephropathy With Sodium Bicarbonate. JAMA. 2004;291:2328-2334. doi: 10.1001/jama.291.19.2328.

Brar SS, Aharonian V, Mansukhani P, Moore N, Shen AY, Jorgensen M, et al. Haemodynamic-guided fluid administration for the prevention of contrast-induced acute kidney injury: the POSEIDON randomised controlled trial. Lancet. 2014;383:1814-1823. doi: 10.1016/S0140-6736(14)60689-9.

McCudden C, Clark EG, Akbari A, Kong J, Kanji S, Hiremath S. N-Acetylcysteine Interference With Creatinine Measurement: An In Vitro Analysis. Kidney International Reports. 2021;6:1973-1976. doi: 10.1016/j.ekir.2021.04.006.

Nyman U, Almén T, Aspelin P, Hellström M, Kristiansson M, Sterner G. Contrast-medium-Induced nephropathy correlated to the ratio between dose in gram iodine and estimated GFR in ml/min. Acta radiologica. 2005;46:830-842. doi: 10.1080/02841850500335051.

Aoun J, Nicolas D, Brown JR, Jaber BL. Maximum allowable contrast dose and prevention of acute kidney injury following cardiovascular procedures. Curr Opin Nephrol Hypertens. 2018;27:121-129. doi: 10.1097/MNH.0000000000000389.

Kidoh M, Nakaura T, Nakamura S, Awai K, Utsunomiya D, Namimoto T, et al. Novel contrast-injection protocol for coronary computed tomographic angiography: contrast-injection protocol customized according to the patient's time-attenuation response. Heart Ves. 2014;29:149-155. doi: 10.1007/s00380-013-0338-x.

Barrett BJ, Carlisle EJ. Metaanalysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media. Radiology. 1993;188:171-178. doi: 10.1148/radiology.188.1.8511292.

Aspelin P, Aubry P, Fransson S-G, Strasser R, Willenbrock R, Berg KJ. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med. 2003;348:491-499. doi: 10.1056/NEJMoa021833.

Marenzi G, Marana I, Lauri G, Assanelli E, Grazi M, Campodonico J, et al. The prevention of radiocontrast-agent-induced nephropathy by hemofiltration. N Engl J Med. 2003;349:1333-1340. doi: 10.1056/NEJMoa023204.

Cruz DN, Perazella MA, Bellomo R, Corradi V, de Cal M, Kuang D, et al. Extracorporeal blood purification therapies for prevention of radiocontrast-induced nephropathy: a systematic review. Am J Kidney Dis. 2006;48:361-371. doi: 10.1053/j.ajkd.2006.05.023.

Su X, Xie X, Liu L, Lv J, Song F, Perkovic V, et al. Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-analysis. Am J Kidney Dis. 2017;69:69-77. doi: 10.1053/j.ajkd.2016.07.033.

Matsushita K, Coresh J, Sang Y, Chalmers J, Fox C, Guallar E, et al. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol. 2015;3:514-525. doi: 10.1016/S2213-8587(15)00040-6.

Bagshaw SM, Ghali WA. Theophylline for prevention of contrast-induced nephropathy. Arch Intern Med. 2005;165 (10):1087-1093. doi: 10.1001/archinte.165.10.1087.

Geng N, Zou D, Chen Y, Ren L, Xu L, Pang W, et al. Prostaglandin E1 administration for prevention of contrast-induced acute kidney injury. Medicine. 2018;97(29):e11416. 10.1097/MD.0000000000011416.

Ma X, Li X, Jiao Z, Zhang Y. Nicorandil for the prevention of contrast-induced nephropathy: A meta-analysis of randomized controlled trials. Cardiovasc Ther.2018;36(2):e12316. doi: 10.1111/1755-5922.12316.

Sadat U, Usman A, Gillard JH, Boyle JR. Does ascorbic acid protect against contrast-induced acute kidney injury in patients undergoing coronary angiography. J Am Coll Cardiol. 2013;62 (23):2167-75. doi: 10.1016/j.jacc.2013.07.065.

Bellos I, Iliopoulos DC, Perrea DN. Allopurinol administration for the prevention of contrast-induced nephropathy: A Network Meta-analysis With Trial Sequential Analysis. J Cardiovasc Pharmacol. 2019;73 (5):307-315. doi: 10.1097/FJC.0000000000000663.

Monami M, Cignarelli A, Pinto S, D'Onofrio L, Milluzzo A, Miccoli R, et al. Alpha-tocopherol and contrast-induced nephropathy: A meta-analysis of randomized controlled trials. Int J Vitam Nutr Res. 2021;91 (1-2):188-196. doi: 10.1024/0300-9831/a000573.

Ye Z, Lu H, Su Q, Guo W, Dai W, Li H, et al. Clinical effect of trimetazidine on prevention of contrast-induced nephropathy in patients with renal insufficiency. Medicine. 2017;96 (9):e6059. doi: 10.1097/MD.0000000000006059.

Pharmacists Association Canadian. Glucophage. In: Compendium of Pharmaceuticals and Specialities: The Canadian Drug Reference for Health Professionals. Ottawa, ON: Canadian Pharmacists Association; 2020.

Morcos SK, Thomsen HS, Webb JAW. Contrast-media-induced nephrotoxicity: a consensus report. Eur Radiol. 1999;9 (8):1602-13. doi: 10.1007/s003300050894.

Stacul F, van der Molen AJ, Reimer P, Webb JA, Thomsen HS, Morcos SK, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol. 2011;21(12):2527-41. doi: 10.1007/s00330-011-2225-0.

Thomsen HS, Morcos SK. Contrast media and metformin: Guidelines to diminish the risk of lactic acidosis in non-insulin-dependent diabetics after administration of contrast media. Eur Radiol. 1999;9(4):738-40. doi: 10.1007/s003300050746.

Whiting P, Morden A, Tomlinson LA, Caskey F, Blakeman T, Tomson C, et al. What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury? A systematic review and meta-analysis. BMJ Open. 2017;7(4):e012674. doi: 10.1136/bmjopen-2016-012674.

https://pubs.rsna.org/doi/10.1148/radiol.13122276">Davenport MS, Khalatbari S, Cohan RH, Dillman JR, Myles JD, Ellis JH. Contrast Material-induced Nephrotoxicity and Intravenous Low-Osmolality Iodinated Contrast Material: Risk Stratification by Using Estimated Glomerular Filtration Rate. Radiology. 2013;268 (3):719-28. doi: 10.1148/radiol.13122276.

Perner A, Prowle J, Joannidis M, Young P, Hjortrup PB, Pettilä V. Fluid management in acute kidney injury. Intensive Care Med. 2017;43(6):807-815. doi: 10.1007/s00134-017-4817-x.

James M, Bouchard J, Ho J, et al. Canadian society of nephrology commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury. Am J Kidney Dis. 2013;61(5):673-85. doi: 10.1053/j.ajkd.2013.02.350.