【译文】造影剂相关急性肾损伤以血管内应用碘造影剂数天后造成肾功能受损为临床特征。20世纪50年代,最早的病例报道是既往肾病的患者静脉肾盂造影时,造影剂与急性肾损伤和其他不良反应的发生率高有关。随着时间的推移,造影剂设计的革新、风险因素识别的改进及预防性护理使得造影剂给药后急性肾损伤发生率减低。最近的研究表明,造影剂造成急性肾损伤的风险被高估了。这些研究的重要性在于,可能因担心造影剂引起急性肾损伤,对存在急性冠状动脉综合征等疾病的慢性肾病患者未能充分实施血管造影术。本综述总结了造影剂相关急性肾损伤的病理生理学、诊断标准和危险分层; 讨论目前关于该病发生率的争议; 并强调了提供预防护理基础证据研究的重要。

【原文】Contrast-associated acute kidney injury is characterized by a decrease in kidney function that occurs within days after the intravascular administration of iodinated contrast material. In the 1950s, initial cases were reported in patients with preexisting kidney disease who were undergoing intravenous pyelography with contrast agents that were associated with a high incidence of acute kidney injury and other adverse effects. Over time, an evolution in the design of contrast agents, improved recognition of risk factors, and implementation of preventive care resulted in lower rates of acute kidney injury after the administration of contrast material. More recent studies have suggested that the risk of acute kidney injury due to contrast material is overestimated. Such studies are important, considering that angiographic procedures may be underused in patients with chronic kidney disease who present with conditions such as acute coronary syndromes, presumably because of concern about precipitating acute kidney injury. This review summarizes the pathophysiology of contrast-associated acute kidney injury, the diagnostic criteria, and risk stratification; discusses current controversies regarding the incidence of this condition; and highlights studies that have provided the evidence that forms the basis for preventive care.1