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Contrast-induced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0.5 mg/dL after percutaneous coronary intervention (PCI) using a contrast agent. Despite extensive speculation, the actual occurrence of contrast-induced nephropathy in other patient populations has not been demonstrated in the literature.〔 〕 ==Risk factors== To minimize the risk for contrast-induced nephropathy, various actions can be taken if the patient has predisposing conditions. These have been reviewed in a meta-analysis. A separate meta-analysis addresses interventions for emergency patients with baseline insufficient kidney function. Three factors have been associated with an increased risk of contrast-induced nephropathy: preexisting decreased kidney function (such as creatinine clearance < 60 mL/min (mL/s ) - (online calculator )), preexisting diabetes mellitus, and reduced intravascular volume. A clinical prediction rule is available to estimate probability of nephropathy (increase ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 h): Risk Factors: * Systolic blood pressure <80 mm Hg - 5 points * Intraarterial balloon pump - 5 points * Congestive heart failure (Class III-IV or history of pulmonary edema) - 5 points * Age >75 y - 4 points * Hematocrit level <39% for men and <35% for women - 3 points * Diabetes mellitus- 3 points * Contrast media volume - 1 point for each 100 mL * Decreased kidney function: * * Serum creatinine level >1.5 g/dL - 4 points :: or * * Estimated Glomerular filtration rate ((online calculator )) : * * 2 for 40–60 mL/min/1.73 m2 : * * 4 for 20–40 mL/min/1.73 m2 : * * 6 for < 20 mL/min/1.73 m2 Scoring: 5 or less points *Risk of CIN - 7.5 *Risk of Dialysis - 0.04% 6–10 points *Risk of CIN - 14.0 *Risk of Dialysis - 0.12% 11–16 points *Risk of CIN - 26.1 * *Risk of Dialysis - 1.09% >16 points *Risk of CIN - 57.3 *Risk of Dialysis - 12.8% 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Contrast-induced nephropathy」の詳細全文を読む スポンサード リンク
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