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Safety and efficacy of anisodamine on prevention of contrast induced nephropathy in patients with acute coronary syndrome

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Chinese Medical Journal 2012年第6期125卷 1063-1067页

作者： WANG Yan-bo FU Xiang-hua GU Xin-shun WANG Xue-chao ZHAO Yu-jun HAO Guo-zhen JIANG Yun-fa FAN Wei-ze WU Wei-li LI Shi-qiang XUE Ling Department of Cardiology Second Hospital of Hebei Medical UniversityShijiazhuangHebei 050000China

Background Previous studies have proved the renal protective effects of anisodamine in patients with septic shock. The aim of this study was to investigate anisodamine for the prevention of contrast induced nephropathy （CIN） in patients with acute coronary syndrome （ACS）. Methods Consecutive ACS patients undergoing elective percutaneous coronary intervention （PCI） were randomly assigned to one of two groups： patients in the anisodamine group （ANI group） were assigned to receive intravenous infusions of anisodamine by an adjusted-dose （0.1-0.2 μg·kg^-1·min^-1） from the PCI procedure to 24 hours after PCI, and the control group （CON group） received 0.9% isotonic saline of the same volume. All patients were hydrated for 6 to 12 hours before and 12 hours after PCI. Blood samples were taken on the day of PCI and at 24, 48 and 72 hours after PCI to measure the serum creatinine （SCr）. Results A total of 177 patients were involved in the study, 88 in the ANI group and 89 in the CON group. In both groups, the SCr concentrations significantly increased after PCI, with the peak value occurring at 48 hours. At 72 hours, the SCr concentration in the ANI group retuned to the baseline level （P 〉0.05）, but the SCr concentration in CON group was still higher than baseline level （P 〈0.01）. The SCr concentrations at 48 and 72 hours after PCI were much lower in the ANI group than those in the CON group （both P 〈0.01）. The estimated glomerular filtration rate （eGFR） significantly decreased after PCI, the lowest value occurred at 48 hours. In the ANI group, the eGFR at 72 hours was similar to the baseline level. In the CON group, the eGFR failed to return to baseline at 72 hours （P〈0.01）. The eGFR at 24, 48 and 72 hours after PCI were higher in the ANI group （all P 〈0.05）. The incidence of CIN in the ANI group was lower than that in the CON group within 72 hours after PCI （P〈0.05）. The results of multiple Logistic regression proved that both diabetes and left ventricular ejection fractio

关键词： acute coronary syndrome percutaneous coronary intervention anisodamine contrast induced nephropathy

contrast-induced nephropathy in Patients with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization

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Open Journal of Radiology 2016年第3期6卷 243-249页

作者： Ryusuke Murakami Hidemasa Saito Izumi Miki Daisuke Yasui Fumie Sugihara Tatsuo Ueda Satoru Murata Hiromitsu Hayashi Shinichiro Kumita Department of Radiology Nippon Medical School Tokyo Japan

Purpose: The purpose of this retrospective study was to assess the incidence and the risk factors of contrast-induced nephropathy (CIN) following transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Materials and Methods: We performed a retrospective review of 186 sessions of TACE in 122 patients with HCC. We examined the incidence and factors associated with risk of CIN, defined as an increase of at least 0.5 mg/dl (44.2 μmol/l) or 25% of the baseline serum creatinine level between 48 and 72 hours after TACE. Results: CIN developed in 14 (7.5%) of the 186 sessions after TACE. A univariate analysis showed that the Child-Pugh class B or C [10/14 (71%) vs. 70/172 (41%), P = 0.046], a low albumin level (3.0 ± 0.5 vs. 3.4 ± 0.6, P = 0.018), and a low hemoglobin level (10.6 ± 2.0 vs. 11.8 ± 2.0, P = 0.035) were significantly associated with the development of CIN. Multivariate analysis revealed that the hemoglobin value was associated with CIN [odds ratio (OR) 1.6;P = 0.038]. Conclusions: CIN after TACE is closely associated with the severity of liver cirrhosis, and with low levels of albumin and hemoglobin. Effective preventive methods remain to be considered in patients with HCC and advanced LC who are undergoing TACE.

关键词： contrast induced nephropathy Hepatocellular Carcinoma Transcatheter Arterial Chemoembolization contrast Media

Renal functional outcomes are not adversely affected by selective angioembolization following percutaneous nephrolithotomy

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Asian Journal of Urology 2017年第1期4卷 27-30页

作者： Ricardo Palmerola Vinay Patel Christopher Hartman Chris Sung David Hoenig Arthur D.Smith Zeph Okeke Smith Institute for Urology Northwell HealthNew Hyde ParkNYUSA Interventional Radiology Northwell HealthNew Hyde ParkNYUSA

Objective:Selective angioembolization(SAE)effectively diagnoses and treats iatrogenic vascular complications following percutaneous nephrolithotomy(PCNL).Methods:We retrospectively reviewed 1329 consecutive PCNLs and identified patients who underwent SAE following PCNL with at least 12-month *** glomerular filtration rate(eGFR)was calculated for all patients preoperatively,postoperatively and at last followup.A 1:2 matched cohort analysis was ***:Twenty-three patients underwent SAE and matched to 46 *** was no statistically significant difference in preoperative,postoperative,and follow-up eGFR when comparing patients who underwent SAE and those with an uneventful ***:Long-term eGFR is comparable in patients who undergo uncomplicated PCNL and those requiring SAE.

关键词： Selective angioembolization Percutaneous nephrolithotomy Urologic complications contrast induced nephropathy Postoperative hemorrhage

Computed tomography pulmonary angiography using a 20% reduction in contrast medium dose delivered in a multiphasic injection

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World Journal of Radiology 2017年第3期9卷 143-147页

作者： Mitchell Chen Gaith Mattar Jamal A Abdulkarim Department of Radiology George Eliot Hospital NHS Trust Department of Radiology University Hospitals Birmingham NHS Trust

AIM To evaluate the feasibility of reducing the dose of iodinated contrast agent in computed tomography pulmonary angiography(CTPA). METHODS One hundred and twenty-seven patients clinically suspected of having pulmonary embolism underwent spiral CTPA, out of whom fifty-seven received 75 mL and the remaining seventy a lower dose of 60 mL of contrast agent. Both doses were administered in a multiphasic injection. A minimum opacification threshold of 250 Hounsfield units(HU) in the main pulmonary artery is used for assessing the technical adequacy of the scans. RESULTS Mean opacification was found to be positively correlated to patient age(Pearson's correlation 0.4255, P contrast at 60 mL can be feasibly used in CTPA without resulting in a higher number of sub-optimally opacified scans.

关键词： Computed tomography pulmonary angiography contrast dose contrast induced nephropathy Acute kidney disease contrast safety contrast dose reduction Multiphasic injection