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首页> 外文期刊>Conference Papers in Science >Use and Misuse of a Biomarker: Contrast-Medium-Induced Nephropathy and Serum Creatinine
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Use and Misuse of a Biomarker: Contrast-Medium-Induced Nephropathy and Serum Creatinine

机译：生物标志物的使用和滥用：造影剂引起的肾病和血清肌酐

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Two different types of contrast media are being used: low-osmolar and isoosmolar contrast media (LOCM, IOCM). Both types induce renal failure. Serum creatinine is routinely used as a marker of renal impairment in many clinical settings. A variety of studies and meta-analyses addressed the differential safety of contrast media with divergent osmolarity. Unfortunately, research in this field is lacking standardized endpoints, as different levels of creatinine increase are used as a surrogate for renal failure, and additionally, serum creatinine levels are influenced by a variety of pathophysiological conditions and thus susceptible for marker artifacts. This is one explanation why conflicting results have been published regarding the different safety of contrast media favoring either LOCM or IOCM. Viscosity which is higher in IOCM rather than osmolarity determines the potential of a CM to induce renal failure. High viscosity reduces flow in renal tubules and vessels and thus impairs renal filtration. Thus, the most effective prevention measure for renal failure is reducing the concentration of contrast media and adequate hydration. In emergency situations, hydration as well as kidney status is commonly unknown, and LOCM are indicated due to their lower viscosity and to their greater water-binding capacity to reduce the risk of renal failure.
机译：使用两种不同类型的造影剂：低渗和等渗造影剂（LOCM，IOCM）。两种类型均引起肾衰竭。在许多临床环境中，血清肌酐通常被用作肾功能损害的标志物。各种研究和荟萃分析探讨了渗透压不同时造影剂的安全性差异。不幸的是，该领域的研究缺乏标准化的终点，因为不同水平的肌酐升高被用作肾衰竭的替代指标，此外，血清肌酐水平受多种病理生理条件的影响，因此易受标记物的影响。这就是为什么在对比剂对LOCM或IOCM有利的不同安全性方面发表了矛盾的结果的原因之一。 IOCM中的粘度高于渗透压，这决定了CM诱发肾衰竭的可能性。高粘度会降低肾小管和血管的流量，从而损害肾滤过。因此，最有效的预防肾衰竭的措施是降低造影剂的浓度和适当的水合作用。在紧急情况下，水合以及肾脏状态通常是未知的，并且由于低黏度和更大的水结合能力降低了肾衰竭的风险，因此显示了LOCM。

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