Kontrast madde nefropatisi

Year 2005, Volume: 12 Issue: 3, 62 - 68, 09.04.2009

Gürkan Acar Selahaddin Akçay Süleyman Aslan Mert Köroğlu Orhan Oyar

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2005 Eylül; 12(3)



Kontrast madde nefropatisi



Gürkan Acar, Selahaddin Akçay, Süleyman Murat Aslan,
Mert Köroğlu, Orhan Oyar



Özet

Kontrast madde nefropatisi (KMN), iyotlu kontrast maddelerin tanısal ve tedavi amaçlı kullanımının artmasıyla birlikte, hastane içinde meydana gelen akut böbrek yetersizliğinin önemli nedenlerinden birisi haline gelmiştir. KMN, hastanın mortalite ve morbiditesini, hastanede kalış süresini ve maliyetini arttırır. Klinik olarak KMN, kontrast madde verdikten sonra böbrek fonksiyonlarındaki akut azalma olarak tanımlanır. Renal medullar hipoksi ve iyotlu kontrast maddelerin renal tübülüsler üzerine olan doğrudan toksik etkisi KMN patofizyolojisinde suçlanan mekanizmalardır. KMN gelişmesi beraberindeki risk faktörlerinin sayısı ile doğrudan ilişkilidir. KMN için tanımlanan pek çok risk faktörü arasında en önemlileri, önceden var olan böbrek yetersizliği, diyabet ve kullanılan kontrast madde miktarıdır. KMN insidansını azaltacak en etkili

yöntem, kontrast madde vermeden önce risk faktörlerini tanımlayarak önlem almaktır. Bu derlemede, KMN'nin risk faktörleri ve patofizyolojisi tartışılmış ve iyotlu kontrast maddelerin bazı özellikleri özetlenmiştir.



Anahtar kelimeler: Kontrast madde nefropatisi, Kontrast maddeler, Risk faktörleri, Patofizyoloji



Abstract



Radiocontrast-induced nephropathy

Radiocontrast-induced nephropathy (CIN) is currently a major cause of hospital-acquired acute renal failure, because of increasing usage of these agents in both diagnostic and interventional procedures. CIN leads to undesirable clinical circumstances which may result in dead as well as increasing length of hospitalisation and high costs. CIN is clinically defined as a sudden decline in renal functions after contrast media administration. The proposed pathophysiologic mechanisms of CIN are renal medullar hypoxia and direct tubuler toxicity of radiocontrast medium. The occurence of CIN is directly related to the number of coexisting clinical risk factors. Some of described risk factors for the developing of CIN are preexisting renal insufficiency, presence of diabetes mellitus and amount of used contrast agent. It is considered that the most effective management at reducing of the incidence of CIN is detection of risk factors mentioned above before administration of contrast medium. In this review we discussed the risk factors and the pathophysiologic mechanisms of CIN, and summarized some of the properties of contrast media.



Key words: Radiocontrast-induced nephropathy, Contrast media, Risk factors, Pathophysiology

Keywords

Kontrast madde nefropatisi, Kontrast maddeler, Risk faktörleri, Patofizyoloji

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