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Rofo 2000; 172(10): 791-797
DOI: 10.1055/s-2000-7889
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© Georg Thieme Verlag Stuttgart · New York

Auswirkungen einer intravasalen Röntgenkontrastmittelgabe auf die Nierenfunktion - Risiken und Prävention

C. M. Erley, B. D. Bader
  • Abteilung Innere Medizin III
  • Sektion Nieren- und Hochdruckkrankheiten, Universität Tübingen
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung.

Das durch Röntgenkontrastmittelgabe initiierte Nierenversagen, die sogenannte Kontrastmittelnephropathie (KMN), stellt - insbesondere bei Patienten mit eingeschränkter Nierenfunktion - nach wie vor ein erhebliches medizinisches Problem dar, dessen Auftreten mit einer deutlich erhöhten Krankenhausmortalität verbunden ist. Die Genese der KMN ist nach wie vor nicht eindeutig geklärt. Neben hämodynamischen Veränderungen durch die Kontrastmittel spielen tubulotoxische Schäden eine Rolle. Die vorliegende Übersicht beschreibt die zur Zeit bekannten pathophysiologischen Vorgänge bei der KMN und die möglichen Präventivmaßnahmen mit besonderem Augenmerk auf die klinisch relevanten Themen der Hydratation, der prophylaktischen Gabe vasoaktiver Substanzen, den Einsatz alternativer Kontrastmittel und die Entfernung von Röntgenkontrastmitteln (KM) mittels Hämodialyse.

Contrast media in renal insufficiency - risk and prevention.

The use of iodinated contrast media (CM) continues to be a common cause of hospital-acquired acute renal failure (ARF) and its development increases the in-hospital mortality significantly. Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity. We review recent insights into the pathogenesis of this complication and summarize prophylactic strategies focussing on hydration, vasoactive pharmacological agents, alternative contrast media and “prophylactic hemodialysis”.

Schlüsselwörter:

Kontrastmittelnephropathie - Hämodialyse - Atrialer Natriuretischer Faktor - Hydratation - Theophyllin - Dopamin

Key words:

Contrast media nephropathy - Theophylline - Hemodialysis - Natriuretic peptide - Hydration - Dopamine

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Priv. Doz. Dr. Christiane M. Erley

Universität Tübingen Abteilung Innere Medizin III

Otfried-Müller-Straße 10

72076 Tübingen

Phone: 07071-29-83469

Fax: 07071-29-2716

Email: christiane.erley@med.uni-tuebingen.de

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