Contrast-induced nephropathy in patients with acute coronary syndrome: clinical significance, diagnosis, prophylaxis

Abstract

In modern medical practice, contrast-induced nephropathy (CIN) is an urgent problem in patients with acute coronary syndrome that underwent percutaneous interventions. It worsens prognosis, increases the number of cardiovascular complications and the length of hospital stay. Despite the use of modern radiocontrast agents, the incidence of CIN can increase in a certain patients up to 50%. Risk factors for CIN can be associated both with the patient and directly with the x-ray procedures. The diagnosis is mainly based on the pre- and postprocedural determination of creatinine. However, more modern biomarkers of kidney injury can be used at present, which allow diagnosing the acute kidney injury as soon as possible. A huge role is played not only by treatment, but also by the prevention of CIN, which consists in the timely identification of high-risk patients. The current study presents the main points of pathogenesis, methods for diagnosing CIN, as well as methods for its prevention and treatment in patients with acute coronary syndrome.

Keywords

• контраст-индуцированная нефропатия
• острый коронарный синдром
• рентген-контрастные препараты
• биомаркеры
• острое почечное повреждение