0 mg/dL is 250 mL (5 mL/kg × 50 kg/L), while that for a patient weighing 70 kg with a SCr of 1.0 mg/dL is 300 mL, rather than 350 mL (5 mL/kg × 70 kg/L). In this study, 115 patients with kidney dysfunction underwent cardiac catheterization and angiography, and the amount of contrast media that was given adhered to the limit in 86 patients TGF-beta/Smad inhibitor and exceeded it in 29 patients. The incidence of CIN was significantly higher in the latter patients (21 %, 6/29 patients) than in the former patients (2 %, 2/86 patients). In a study of 391 patients who underwent PCI, the independent predictors of CIN were the volume of contrast media, eGFR, LVEF, and cardiogenic shock [52]. The risk of CIN was 25 %
among patients with a contrast medium dose-to-eGFR ratio (gram-iodine/eGFR) of ≥1, which was significantly higher than that in those with a gram-iodine/eGFR of <1 (3 %). A study of patients undergoing PCI investigated the effects of contrast volume on the incidence of AKI, defined as a ≥0.3 mg/dL or ≥50 % increase in SCr levels from baseline, in subgroups of patients stratified according to categories in which 1.0 represents the “maximum allowable contrast dose” (MACD; calculated by using the formula described earlier [51]), of <0.5, 0.5–0.75, 0.75–1.0, 1.0–1.5, 1.5–2.0, and >2.0 [53].
The incidence click here of AKI did not differ significantly among subgroups with a MACD ratio of ≤1, but increased in subgroups of patients with an MACD ratio of 1.0–1.5 (OR 1.60, 95 % CI 1.29–1.97), 1.5–2.0 (OR 2.02, 95 % CI 1.45–2.81), and >2.0 (OR 2.94, 95 % CI 1.93–4.48). The incremental use of contrast is associated with an increased risk of AKI. In a study of 421 patients who underwent contrast-enhanced CT with intravenous iodinated contrast media, Weisbord et al. [5] reported that the use of >100 mL of contrast media was associated with an increased risk of CIN (OR: 3.3, 95 % CI 1.0–11.5). Is the risk for developing CIN lower in patients receiving low- rather than high-osmolar contrast media? Answer: Patients with a high risk for
developing CIN should receive low-osmolar contrast media, which are less associated with CIN as compared with high-osmolar contrast media. In Japan, high-osmolar contrast media are not indicated for intravascular use. Does the risk for developing CIN differ Methane monooxygenase between iso- and low-osmolar contrast media? Answer: There has been no definite conclusion as to whether the risk of CIN differs between iso- and low-osmolar contrast media. Does the risk for developing CIN differ among different low-osmolar contrast media? Answer: There has been no definite conclusion as to whether the incidence of CIN differs among different low-osmolar contrast media. In a meta-analysis of 31 studies, that the selleck pooled odds of CKD (defined as a rise of SCr levels of more than 44 μmol/L) with non-ionic low-osmolar contrast media was 0.61 (95 % CI 0.48–0.77) times that of ionic high-osmolar contrast media [54].