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首页> 外文期刊>Cardiovascular therapeutics >Is angiotensin-converting enzyme inhibitor a contraindication for contrast-induced nephropathy prophylaxis? a review about its paradox
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Is angiotensin-converting enzyme inhibitor a contraindication for contrast-induced nephropathy prophylaxis? a review about its paradox

机译：血管紧张素转换酶抑制剂是否是预防造影剂肾病的禁忌症？关于其悖论的评论

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Contrast-induced nephropathy (CIN) is reported to be the third leading cause of acute renal failure. The role of angiotensin-converting enzyme (ACE) inhibitors in CIN is controversial. Some studies pointed out that it was effective in the prevention of CIN, while some concluded that it was associated with increased risk of CIN, especially for patients with preexisting renal impairment. Nevertheless, it is a common practice in many centers to prescribe ACE inhibitors before coronary angiography. The most likely mechanisms leading to CIN are medullary hypoxia due to decreased renal blood flow (RBF) secondary to renal artery vasoconstriction and direct tubular toxicity by contrast medium (CM). Furthermore, experimental data suggest that an activated renin-angiotensin-aldosterone system, increased endothelin-1, and reactive oxygen species play a role in the pathogenesis of CIN and these can be inhibited by using ACE inhibitors. In this context, we review the medical literatures and discuss the pathogenesis, the role of renin-angiotensin-aldosterone system on the development of CIN and ACE inhibitors' effect on CIN.
机译：据报道，造影剂诱发的肾病（CIN）是急性肾衰竭的第三大原因。血管紧张素转换酶（ACE）抑制剂在CIN中的作用是有争议的。一些研究指出，它可有效预防CIN，而另一些研究则认为，它与CIN风险增加有关，尤其是对于已有肾功能不全的患者。然而，在许多中心，在冠状动脉造影之前开出ACE抑制剂是一种常见的做法。导致CIN的最可能机制是由于继​​发于肾动脉血管收缩的肾血流量减少（RBF）而引起的髓质缺氧和造影剂（CM）引起的直接肾小管毒性。此外，实验数据表明，激活的肾素-血管紧张素-醛固酮系统，内皮素-1的增加和活性氧在CIN的发病机理中起作用，这些都可以通过使用ACE抑制剂来抑制。在这种情况下，我们回顾医学文献并讨论其发病机理，肾素-血管紧张素-醛固酮系统在CIN发生中的作用以及ACE抑制剂对CIN的作用。

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