Renal Imaging in Patients with Renal Impairment.
Summary of "Renal Imaging in Patients with Renal Impairment."
In patients with renal impairment, the incremental benefits from administration of contrast media for imaging studies need to be carefully assessed relative to the potential increased risks of worsening renal dysfunction and systemic adverse effects. This review provides an overview of risk and benefits of iodinated and gadolinium-based contrast agents; examines their relationships to contrast-induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF), respectively; and discusses various clinical strategies to minimize the risk of CIN and NSF. Specifically, renal imaging strategies aimed to minimize the adverse effects of contrast media as well as alternatives to iodinated and gadolinium-based contrast-enhanced renal imaging are proposed with emphasis on non-contrast-enhanced magnetic resonance imaging.
Affiliation
Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Journal Details
This article was published in the following journal.
Name: Current urology reports
ISSN: 1534-6285
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21128027
- DOI: http://dx.doi.org/10.1007/s11934-010-0158-9
Medical and Biotech [MESH] Definitions
Probenecid
The prototypical uricosuric agent. It inhibits the renal excretion of organic anions and reduces tubular reabsorption of urate. Probenecid has also been used to treat patients with renal impairment, and, because it reduces the renal tubular excretion of other drugs, has been used as an adjunct to antibacterial therapy.
Renal Plasma Flow
The amount of PLASMA that perfuses the KIDNEYS per unit time, approximately 10% greater than effective renal plasma flow (RENAL PLASMA FLOW, EFFECTIVE). It should be differentiated from the RENAL BLOOD FLOW; (RBF), which refers to the total volume of BLOOD flowing through the renal vasculature, while the renal plasma flow refers to the rate of plasma flow (RPF).
Hypertension, Renal
Persistent high BLOOD PRESSURE due to KIDNEY DISEASES, such as those involving the renal parenchyma, the renal vasculature, or tumors that secrete RENIN.
Hepatorenal Syndrome
Functional KIDNEY FAILURE in patients with liver disease, usually LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL), and in the absence of intrinsic renal disease or kidney abnormality. It is characterized by intense renal vasculature constriction, reduced renal blood flow, OLIGURIA, and sodium retention.
Renal Insufficiency
Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE. The most severe form is KIDNEY FAILURE. Renal function may deteriorate slowly (RENAL INSUFFICIENCY, CHRONIC) or precipitously (RENAL INSUFFICIENCY, ACUTE).
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