| Prevención nefropatía por contraste | |
| E.Antón, R.Pitarch. | |
| Servicio de Medicina Intensiva. Hospital de Manacor. | |
| Julio 2008 | |
| Manejo-Algoritmo | |
| Evaluación del riesgo: Cáculo score | |
| Valoración/prevención | |
| Pauta de prevención:Cálculo de dosis | |
| Bibliografía | |
| Valorar y Prevenir : | |
| Necesidad de contraste intravenoso | |
| Uso de métodos de imagen alternativos | |
| Evitar contrastes de elevada osmolalidad | |
| Usar el mínimo volumen posible de contraste | |
| Evitar repetir estudios | |
| Evitar depleción de volumen | |
| Asegurar una adecuada hidratación | |
| Evitar fármacos nefrotóxicos (AINEs) | |
| Valorar suspensión de diuréticos el día previo | |
| Valorar suspensión de metformina en días previos (riesgo de desarrollar acidosis láctica) | |
| Bibliografía | |
| Briguori C et al. Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL) A Randomized Comparison of 3 Preventive Strategies. Circulation 2007, 115 1211-1217 | |
| Barret B. Acetylcysteine in the prevention of contrast-induced nephropathy A case study of the pitfall in theevolution of evidence NEJM 2006; 354: 379-386 | |
| Chertow G. Prevention of radiocontrast nephropathy JAMA 2004, 291;2376-2377 | |
| Mueller, C. Et al. Incidence of contrat nephropathy in patients receving comprehensive intravenous and oral volumen supplementation Swiss Med Wkly 2005, 135:286-290 | |
| Charanjit, SR. Incidence and Prognostic importance of acute renal failure after percutaneus coronary intervention. Circulation 2002 2259-2265 | |
| Marenzi G. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infraction JACC 2004; 44: 1779-1785 | |
| A simple risk score for prediction of acute renal failure after percutaneus coronary intervention. JACC 2004; 44: :1393-9 | |
| Mueller C. Et al. Prevention of Contrast Media - Associated Nephropathy Randomized Comparison of 2 hydration regimen in 1620 patients undergoing coronary angioplasty. Arch Intern Med 2002, 162: 329-336 | |
| Merten GJ, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate A randomized Controlled Trial JAMA 2004, 291: 2328-2334 | |
| Bagshaw S, et al. Acetylcysteine in the prevention of Contrast-Induced Nephropathy A case study of the pitfalls in the Evolution of Evidence. Arch Intern Med 2006, 166:161-166 | |
| Kay J et al. Acetylcysteine for prevention of acute deterioration of renal funcion following elective coronary angiography and intervention A randomized Controlled Trial JAMA 2003, 289: 553-558 | |
| Baker, C et al. A rapid protocol for the prevention of contrast-induced renal dysfunction: the RAPPID study. JACC 2003, 41: 2114-2118 | |
| Giancarlo M et al. N England J Med 2006, 354 (26) 2773-2782 | |
| Nash K. American J Kidney Dis 2003;39:930-6 Hospital adquired renal insufficiency | |
| Levy EM, JAMA 1996; 275:1489-1494. The effect of acute renal failure on mortaliy: a cohort analysis | |
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